The main negative consequence of many dietary restrictions due to a large number of diseases is metabolic disorders and protein deficiency in the body. Significant changes in nutritional status indicators are typical primarily for patients with chronic kidney disease of various origins. The pre-dialysis stage of CKD is a condition that requires significant restriction of protein nutrition in accordance with the degree of reduction in glomerular filtration rate, since this provides a real inhibition of the progression of renal dysfunction. However, the transition to dialysis treatment completely changes approaches to dietary nutrition for patients with end-stage CKD. In such a situation, a prerequisite for improving the quality of life of dialysis patients is the complete elimination of protein-energy deficiency by consuming protein products in the range of 1.0-1.3 g/kg/day with a slight restriction of salt, and the diet should have a calorie content of at least 35 kcal/ kg/day. The energy value of food is determined by calculating the percentage of proteins, fats and carbohydrates in it. In addition, dialysis patients should receive nutrition that replenishes the loss of a number of microelements, namely: selenium, zinc, iron, manganese, etc. An important aspect of proper nutrition in the terminal phase of CKD in dialysis patients is the use of complex vitamin therapy, including the administration of vitamins B, C, D, E.

               The above-described modern principles of dietary therapy for CKD are used on an ongoing basis by nephrology residents during the supervision of inpatients and outpatients, which ensures higher reliability of the theoretical knowledge obtained, and also forms in future specialists an integrated approach to the treatment of this syndrome.

Associate Professor of the Department of Internal Medicine and Rheumatology

Kapanova G.K.