ABSTRACT
Chronic kidney disease Stage 4 (CKD 4) is a transitional stage with signi”cant management challenges due to the wide variation in symptoms, lab values, and overall patient presentation. Nutrition plays a key role not only in the management of progression of the disease but also in minimizing the impact of the comorbidities seen in patients. Nutrition also affects the presentation of symptoms and long-term outcome of treatment of these patients when they undergo renal replacement therapy (RRT). Nutrition management during this critical predialysis stage must be individualized and closely monitored to maximize ef”cacy and avoid overrestriction of dietary intake.
