Joint International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) Practice Recommendation on Nutrition Management in Peritoneal Dialysis.

Angela Yee-Moon Wang, Carla Maria Avesani, Deepa Kariyawasam, Kelly Lambert, Christine Nash, Fabiana Nerbass, Alice Sabatino, Ammar Alobaidi, Sharon Devi Naraine, Maria Chan, Josephine Sf Chow, Jie Dong, Zarina Ebrahim, Ana E Figueiredo, Scott E Liebman, Connie Rhee, Maryanne Zilli Canedo Silva, David W Johnson

Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2026;36(5):654-713

PMID: 42790999

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Abstract

Nutrition is a key management issue in individuals receiving peritoneal dialysis (PD) and those who develop complications during PD. However, globally, there is no unified practice consensus to guide nephrologists, dietitians and other allied health professionals in managing various nutrition issues for individuals receiving PD. The International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) joined forces to develop an inaugural practice recommendation on nutrition management in individuals receiving PD. The practice recommendation was developed by a globally representative group of nephrologists, dietitians, and dialysis nurses. It aims to provide comprehensive clinical guidance on nutrition management to nephrologists, non-nephrologists physicians, dietitians, nurses and multidisciplinary care team for implementation in individuals receiving PD to optimize their nutrition status, prevent and manage protein-energy wasting (PEW), promote a healthy dietary pattern, improve patient-centred outcomes, enabling them to live well on PD. A multidisciplinary education approach is promoted to improve patients' health, nutrition and food literacy in order for them to adopt a healthy dietary pattern and promote more individuals' engagement in self-managing their diets and nutrition. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to evaluate the quality of evidence and grade practice recommendations. Practice points are developed based on expert consensus of health professionals. The practice recommendation covers 5 key themed topics: nutrition screening and assessment and monitoring of nutrition status, dietary recommendations for individuals receiving PD, nutrition interventions for individuals who develop complications while receiving PD, nutrition supplementation and nutrition education.

Address: Department of Renal Medicine, Singapore General Hospital, Singapore; Duke-National University of Singapore (NUS), Singapore. Electronic address: [email protected].; Division of Renal Medicine, Department of Clinical Science, Renal Research Novum, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.; Department of Dietetics, King's College Hospital NHS Foundation Trust, London, UK.; School of Medical, Indigenous and Health Sciences, University of Wollongong, Australia.; Division of Nephrology, Department of Allied Health - Clinical Nutrition, University Health Network, Toronto, Ontario, Canada.; Division of Nephrology, Fundação Pró-Rim, Joinville, Santa Catarina, Brazil.; Närlunda Primary Care Center, Helsingborg, Sweden.; Home Peritoneal Dialysis Unit, Toronto General Hospital, Toronto, Ontario, Canada.; School of Medical, Indigenous and Health Sciences, University of Wollongong, Australia; Department of Nutrition and Dietetics, The St. George Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.; Faculty of Medicine, University of New South Wales, Sydney, Australia; South Western Sydney Nursing and Midwifery Research Alliance, South Western Sydney Local Health District, Sydney, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia; School of Health Science, University of Tasmania, Tasmania, Australia; NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith, Australia.; Renal Division, Department of Medicine, Peking University First Hospital.; Faculty of Medicine and Health Sciences, Division of Human Nutrition, Department of Global Health, Stellenbosch University, South Africa.; School of Health Science and Life- Nursing School- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.; Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York.; Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California; Nephrology Section, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.; Department of Internal Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.; Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia.

DOI: 10.1053/j.jrn.2026.08.002

MeSH Terms: Humans, Peritoneal Dialysis, Nutritional Status, Protein-Energy Malnutrition