The challenge of nutritional management in people with kidney disease.

This is the peer reviewed version of the following article:Langley-Evans, S. and Thomas, N. (2017), The challenge of nutritional management in people with kidney disease. Journal Human Nutrition Dietetics, 30: 679–680. doi:10.1111/jhn.12525 , which has been published in final form at doi:10.1111/jhn.12525. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. The impairment of metabolic functions associated with chronic kidney disease (CKD) requires dietary modification in order to prevent more rapid progression of disease and the development of co-morbidities such as hypertension. In the early stages of disease, dietary modification such as reduction of sodium intake, is usuallythe only treatment offered to patients, but as disease progresses, more major modifications become a critical adjunct to treatments such as haemodialysis. Dietary modifications in those with advanced kidney disease will extend to management of potassium and phosphorus intake and control over fluid balance for people requiring dialysis. Co-morbidities which increase renal injury and promote disease progression, primarily diabetes, will also require dietary management. The nutrition of people with kidney disease is therefore highly complex, necessitating high levels of patient engagement with clinical input.