First regional consensus on renal nutrition: recommendations for the management of patients with chronic kidney disease

Karen Courville, Unidad de Hemodiálisis, Departamento de Nefrología, Hospital Dr. Gustavo N. Collado, Herrera, Panamá; Sistema Nacional de Investigación, SNI, SENACYT, Ciudad de Panamá, Panamá
Guillermo Rodríguez-Méndez, Servicio de Nefrología, Hospital Calderón Guardia, San José, Costa Rica
Blandina Solís-Morales, Hospital General de Enfermedades Instituto Guatemalteco de Seguridad Social, Guatemala, Guatemala
Cristina Brolo-España, Clínica Privada Clinuré, Ciudad de Guatemala, Guatemala
Mabel Sandoval-Díaz, Hospital Infantil y Hospital Vivian Pellas, Managua, Nicaragua
Paola Sánchez-Corrales, Unidad de Soporte Nutricional, Hospital Calderón Guardia, San José, Costa Rica
Mario Espinach-Roel, Servicio de Nefrología, Hospital Calderón Guardia San José, Costa Rica
Laura Maroto-Meneses, Servicio de Nutrición, Hospital Calderón Guardia, San José, Costa Rica
Katya Velasco-Escobar, Servicio de Nutrición Clínica, Hospital Médico Quirúrgico, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador
Jessenia Nóchez, Servicio de Nutrición Clínica, Hospital Médico Quirúrgico, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador
Jimmy Morán-Alvarado, Servicio de Nutrición Clínica, Hospital Médico Quirúrgico, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador
Melissa Arias-Tróchez, Departamento de Nutrición de la Universidad Autónoma de Honduras, Tegucigalpa, Honduras
Carolina Rodríguez-Canaca, Servicio de Nefrología Pediátrica, Hospital María Especialidades Pediátricas, Tegucigalpa, Honduras
Ángeles de Gracia-Domínguez, Departamento de Nutrición, Hospital Dr. Gustavo N. Collado, Herrera, Panamá
Rosa Larreategui-Arosemena, Unidad de Soporte Nutricional, Hospital Ciudad de La Salud, Caja de Seguro Social, Panamá, Panamá
Ricardo Marte-Álvarez, Hospital General Fuerzas Armadas, Santo Domingo, República Dominicana
Norda Figueroa-Toribio, Unidad de Nutrición, Hospital Padre Billini, Santo Domingo, República Dominicana
Wanda Rodríguez-Díaz, Hospital Padre Billini y Centro de Ginecología y Obstetricia, Santo Domingo, República Dominicana
Guillermo Álvarez-Estévez, Departamento de Nefrología, Coordinación de Residencia de Nefrología CEDIMAT, Santo Domingo, República Dominicana
Vicente Sánchez-Polo, Posgrado en Nefrología, Facultad de Medicina, Universidad de San Carlos, Sociedad Latinoamericana de Nefrología e Hipertensión (SLANH) Guatemala, Guatemala

Objective: To assess the current status of chronic kidney disease (CKD) in the nutritional context and generate recommendations for the medical and nutritional management of patients with CKD in Central America and the Caribbean. Material and methods: Expert meetings (nephrologists, nutritionists, internists, and nutritionists) were held virtually and in person during 2022 and 2024. International guidelines on nutrition in CKD were reviewed, considering the country-specific situational assessment, nutritional diagnosis and intervention, and management recommendations. Results: A lack of data on the prevalence and incidence of CKD and its nutritional complications in the region was identified. Recommendations were developed for nutritional screening, evaluation, diagnosis, and intervention at different stages of CKD and renal replacement therapy, including guidelines on dietary prescription, meal plans, nutritional education, and follow-up. Conclusions: This document provides a regional expert consensus to standardize nutritional management of CKD patients in Central America and the Caribbean, highlighting the importance of individualized treatment and the need for a multidisciplinary approach. Its unique feature lies in the adaptation of international guidelines to the specific characteristics of the region.

Keywords: Chronic kidney disease. Nutrition. Protein-energy wasting. Diet. Albumin. Dialysis.