Kidney Week

Abstract: SA-PO0896

Strict Adherence to CKD Dietary Guidelines May Paradoxically Disturb Overall Nutritional Balance

Session Information

• Health Maintenance, Nutrition, and Metabolism
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Ichinose, Hitomi, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Hitomi Ichinose, RD

• Moriya, Reika Flora, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Reika Flora Moriya, MD

• Tanaka, Kenichi, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Kenichi Tanaka, MD, PhD

• Kabasawa, Hideyuki, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Hideyuki Kabasawa, MD, PhD

• Hosojima, Michihiro, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Michihiro Hosojima, MD, PhD

• Kazama, Sakumi, Ohu Daigaku Shigakubu Daigakuin Shigaku Kenkyuka, Koriyama, Fukushima Prefecture, Japan

Sakumi Kazama, MD, PhD

• Kazama, Junichiro James, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima Prefecture, Japan

Junichiro James Kazama, MD, PhD

Background

The CKD Dietary Guidelines established by the Japanese Society of Nephrology recommend for patients with CKD stage 3b: (1) energy intake of 25–35 kcal/kgBW/day, (2) protein intake of 0.6–0.8 g/kgBW/day, (3) salt intake ≤6.0 g/day, and (4) potassium intake ≤2000 mg/day. However, the impact of adherence to these four requirements on overall nutritional balance remains unclear.

Methods

Registered dietitians working in Japan were invited to design an attractive one-day meal plan for a hypothetical patient: a 60-year-old man, height 168 cm, body weight 60 kg, estimated glomerular filtration rate 44.5 mL/min/1.73 m², and urinary protein-to-creatinine ratio 1.24, without diabetes mellitus, hyperuricemia, or dyslipidemia. Meal plans were required to comply with the Japanese Society of Nephrology CKD Dietary Guidelines. Submitted meal plans were additionally analyzed for lipid, carbohydrate, mineral, and vitamin contents. Participating dietitians were not informed beforehand that nutrients other than the four guideline items would be analyzed.

Results

All submitted meal plans satisfied the four guideline requirements, and lipid, carbohydrate, and cholesterol contents were generally within target ranges. In contrast, deficiencies were observed in multiple minerals and vitamins: calcium, 52% of the estimated average requirement (EAR) and 42% of the recommended dietary allowance (RDA); magnesium, 57% EAR and 48% RDA; zinc, 69% EAR and 58% RDA; vitamin A, 63% EAR and 50% RDA; vitamin B1, 87% EAR and 63% RDA; vitamin B2, 61% EAR and 49% RDA; vitamin B6, 83% EAR and 67% RDA; and niacin, 91% EAR and 78% RDA.

Conclusion

Meal plans designed solely to satisfy the four parameters specified in the CKD Dietary Guidelines resulted in insufficient intake of various minerals and vitamins. Dietary counseling for CKD patients should emphasize overall nutritional balance in addition to restriction of selected nutrients.

Funding

• Private Foundation Support