《KDOQI慢性肾脏病营养临床实践指南2020更新版》解读

2020年9月，国家肾脏基金会肾病预后质量倡议（KDOQI）发布《KDOQI慢性肾病营养临床实践指南2020更新版》。20年前KDOQI发布首个终末期肾病患者营养指南，20年来营养管理的新证据不断出现。更新指南不仅包括终末期肾病或晚期慢性肾脏病（CKD）患者，还包括未接受透析的1~5期CKD患者和肾移植患者。更新指南内容涵盖6个领域：营养评估、医学营养治疗、膳食蛋白质和能量摄入、营养补充剂、微量营养素和电解质。主要包括饮食管理，而不是所有可能的营养干预。本文对其中主要内容进行解读，并结合我国实际情况进行讨论。

Interpretation of the KDOQI Clinical Practice Guideline for Nutrition in CKD:2020 Update

In September 2020,The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative(KDOQI)updated its clinical practice guideline for nutrition in CKD.Since the publication of the initial KDOQI nutrition guideline 20 years ago,there has been a great accumulation of new evidence about the nutritional management of kidney disease.The guideline was expanded to include patients with end-stage kidney disease or advanced CKD,patients with stages 1-5 CKD without ongoing dialysis and patients with a functional kidney transplant.The updated guideline statements cover 6 primary areas:nutritional assessment,medical nutrition therapy,dietary protein and energy intake,nutritional supplementation,micronutrients,and electrolytes.The guidelines mainly include dietary management rather than all possible nutritional interventions.Focusing on the main contents of the guideline,the paper interpreted main recommendations and discussed the application in light of the actual situation in China.