Abstract
The estimated energy requirement for the majority of patients with chronic kidney disease (CKD) is 25–35
kcal/kg/day, but it should be set for individual patients in consideration of their gender, age, and physical activity
level. Dietary prescription should be assessed and optimized over time by monitoring the changes in the body
weight of the patients. The Evidence-based Clinical Practice Guidelines for Chronic Kidney Disease 2018 established by the Japanese Society of Nephrology recommend individualized protein restriction for patients with CKD
in accordance with their specific clinical condition, in addition to nutrition guidance consisting of a low protein
diet under the management of the medical team with nephrologists and registered dietitians. To prevent hypertension, proteinuria, and cardiovascular disease (CVD), salt intake should be restricted to below 6 g/day. It is
recommended to set a lower limit for each patient of 3 g/day as a guide because extreme salt restriction could be
harmful. It was also suggested that serum potassium levels should be maintained between 4.0 and 5.4 mEq/L to
support the reduction of mortality and CVD in patients with CKD.
