Nutrition optimization can be a beneficial intervention in slowing down the
progression of chronic kidney disease (CKD). Oftentimes, especially in obese patients
with CKD, nutritional interventions are complex; involve carbohydrate and lipid
restrictive strategies in addition to limitations in protein intake of poor biological value.
Given the long time course CKD can take in individuals and given the unpredictable
nature of CKD which varies between individuals, it is essential that periodic long term
follow up with any nutritional intervention in any patient be rigorously monitored to
assess adherence to dietary regimen and avoid ill consequences of too strict of a
strategy. Unfortunately, long-term outcomes data of optimal dietary interventional
strategies and intake of various nutrients for patients with CKD are lacking, especially
for obese diabetic patients. Nevertheless, understanding the effects of adequate and
inadequate nutrition in renal disease can help clinicians and patients work together to
modify key risk factors that impact CKD progression. This chapter reviews the
aberrancies and pathophysiological mechanisms that are associated with various microand
macro-nutrient imbalances and how those imbalances can impact CKD and other
comorbidities, especially in patients suffering from metabolic syndrome and obesity.
Keywords: Chronic kidney disease, Metabolic syndrome, Mineral bone disease,
Nutrition, Obesity, Protein energy wasting syndrome.
