OpenLB
Open Library of Bioscience
Advanced Search
Biomedicines
Apr 19, 2025;13 (4):

Critical Review of the Benefit from Early Pharmacological and Dietary Support for Patients with Moderate-to-Severe (Non-Terminal) Chronic Kidney Disease.

Charline Danneel, Camille Sauvage, Mohamed Nabil Hayef, Véronique Desmet, Murielle Surquin, Joëlle Nortier, Carine De Vriese
Author Information
  1. Charline Danneel: Department of Pharmacy, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium. ORCID
  2. Camille Sauvage: Department of Dietetics, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
  3. Mohamed Nabil Hayef: Department of Pharmacy, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
  4. Véronique Desmet: Department of Dietetics, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
  5. Murielle Surquin: Department of Geriatrics, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
  6. Joëlle Nortier: Department of Nephrology-Dialysis, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
  7. Carine De Vriese: Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium. ORCID
PMID: 40299642 DOI: 10.3390/biomedicines13040994

Abstract

Moderate-to-severe chronic kidney disease (CKD) is a public health problem affecting hundreds of millions of people around the world. Started early, nephroprotection measures are able to prevent the degradation of renal function and are a major issue in CKD management. This approach consists of a combination of pharmacological and non-pharmacological treatments aimed at slowing down the decline in renal filtration capacity and improving patient well-being. Drugs such as angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and sodium-glucose cotransport type 2 inhibitors play a crucial role in reducing intraglomerular pressure and renal inflammation. Their beneficial effects are potentiated when they are combined with non-pharmacological approaches, such as salt and protein restriction. This present review provides a critical overview of the current pharmacological and nutritional therapies that may slow down the progression of CKD. Recently, many pharmacological treatments have opened up new perspectives for managing this condition. Nevertheless, prevention remains the cornerstone of effective disease management. Actually, very few studies include both pharmacists and dietitians in their interdisciplinary team mainly represented by nephrologists, nurses, and social workers. However, their specific collaboration may significantly improve the knowledge and skills to help patients in their own CKD management. Future research is required to assess the benefit of collaboration in supporting patients with moderate-to-severe CKD before any concern of renal replacement therapy (RRT).

Keywords

chronic kidney disease dietitian interdisciplinary team nephroprotection patient education pharmacist polypharmacy

References

Nephrol Dial Transplant. 2017 Mar 1;32(3):475-487 [PMID: 28339863]
Am J Kidney Dis. 2016 May;67(5):728-41 [PMID: 26597926]
Clin Ther. 2023 Nov;45(11):e217-e221 [PMID: 37722957]
Indian J Nephrol. 2025 Mar-Apr;35(2):178-186 [PMID: 40060062]
Nephrol Dial Transplant. 2022 Mar 25;37(4):730-739 [PMID: 33576809]
Nephrol Dial Transplant. 2024 Apr 26;39(5):770-777 [PMID: 38012124]
Kidney Int. 2018 May;93(5):1060-1072 [PMID: 29580635]
Adv Chronic Kidney Dis. 2022 Jul;29(4):329-336 [PMID: 36175070]
Electrolyte Blood Press. 2021 Dec;19(2):29-37 [PMID: 35003283]
Nicotine Tob Res. 2021 Jan 7;23(1):92-98 [PMID: 32364601]
Adv Ther. 2024 Apr;41(4):1318-1324 [PMID: 38443646]
Lancet. 2022 Nov 19;400(10365):1788-1801 [PMID: 36351458]
Clin Kidney J. 2021 Oct 29;15(3):442-451 [PMID: 35296039]
Kidney360. 2022 Jan 14;3(4):752-778 [PMID: 35721622]
West J Nurs Res. 2020 Nov;42(11):937-947 [PMID: 32009550]
Drugs. 2019 Mar;79(4):365-379 [PMID: 30758803]
BMJ Open. 2018 Mar 22;8(3):e019814 [PMID: 29567848]
J Nephrol. 2024 Jan;37(1):77-93 [PMID: 38165561]
Kidney Int Suppl (2011). 2022 Apr;12(1):7-11 [PMID: 35529086]
Am J Kidney Dis. 2010 Mar;55(3):441-51 [PMID: 19962808]
Lancet. 2021 Aug 28;398(10302):786-802 [PMID: 34175022]
J Clin Transl Endocrinol. 2024 May 22;36:100354 [PMID: 38828402]
BMC Public Health. 2025 Feb 7;25(1):511 [PMID: 39920675]
World J Nephrol. 2024 Mar 25;13(1):89637 [PMID: 38596266]
BMC Nephrol. 2016 Sep 08;17(1):127 [PMID: 27609359]
J Ren Nutr. 2023 Nov;33(6S):S56-S66 [PMID: 37394104]
Am J Kidney Dis. 2022 Mar;79(3):437-449 [PMID: 34862042]
Nutrients. 2023 Mar 02;15(5): [PMID: 36904256]
BMC Nephrol. 2024 Dec 18;25(1):463 [PMID: 39696084]
Semin Nephrol. 2023 Mar;43(2):151404 [PMID: 37598539]
J Am Soc Nephrol. 2021 Jan;32(1):239-253 [PMID: 32868398]
Eur J Clin Nutr. 2021 Sep;75(9):1389-1397 [PMID: 33531632]
Am J Kidney Dis. 2019 Feb;73(2):248-257 [PMID: 30149957]
Int Urol Nephrol. 2020 May;52(5):903-916 [PMID: 32236780]
Nephrol Dial Transplant. 2025 Apr 01;40(4):751-767 [PMID: 39277780]
Clin Kidney J. 2018 Dec;11(6):749-761 [PMID: 30524708]
Am J Kidney Dis. 2005 Jun;45(6):1105-18 [PMID: 15957142]
PLoS One. 2018 Nov 7;13(11):e0206134 [PMID: 30403710]
BMJ Open. 2016 May 12;6(5):e010708 [PMID: 27173809]
J Hypertens. 2023 Dec 1;41(12):1874-2071 [PMID: 37345492]
Clin Kidney J. 2024 Nov 22;17(Suppl 2):36-50 [PMID: 39583143]
BMC Nephrol. 2019 Apr 26;20(1):142 [PMID: 31027481]
Am J Health Syst Pharm. 2023 Nov 22;80(23):1708-1721 [PMID: 37632460]
Worldviews Evid Based Nurs. 2021 Feb;18(1):33-41 [PMID: 33247619]
Clin Kidney J. 2018 Aug;11(4):507-512 [PMID: 30087772]
Kidney Int Suppl (2011). 2017 Jul;7(1):1-59 [PMID: 30675420]
J Clin Med. 2021 Jan 22;10(3): [PMID: 33499035]
Nutrients. 2023 Jun 12;15(12): [PMID: 37375619]
Asian Biomed (Res Rev News). 2024 Mar 20;18(1):2-10 [PMID: 38515633]
J Am Pharm Assoc (2003). 2023 Mar-Apr;63(2):681-689 [PMID: 36593152]
BMC Nephrol. 2024 Apr 22;25(1):140 [PMID: 38649939]
Int J Vitam Nutr Res. 2022 Jul;92(3-4):267-279 [PMID: 32138628]
Kidney360. 2024 Jun 1;5(6):841-850 [PMID: 38661553]
Br J Clin Pharmacol. 2018 Dec;84(12):2811-2823 [PMID: 30110711]
BMC Nephrol. 2023 May 26;24(1):149 [PMID: 37237342]
Am J Med Sci. 2024 Jan;367(1):4-13 [PMID: 37832917]
Clin J Am Soc Nephrol. 2024 Aug 1;19(8):959-969 [PMID: 38980732]
Front Med (Lausanne). 2021 Jun 25;8:654250 [PMID: 34249961]
Clin Kidney J. 2024 Dec 02;18(2):sfae380 [PMID: 39906070]
N Engl J Med. 2024 Jul 11;391(2):109-121 [PMID: 38785209]
PLoS Med. 2018 Mar 27;15(3):e1002532 [PMID: 29584720]
Diabetes Obes Metab. 2021 Dec;23(12):2825-2826 [PMID: 34387935]
J Hum Nutr Diet. 2021 Aug;34(4):736-746 [PMID: 33497513]
Nutrients. 2021 Sep 19;13(9): [PMID: 34579153]
BMC Nephrol. 2015 Oct 12;16:161 [PMID: 26458811]
Nutrients. 2020 Jun 29;12(7): [PMID: 32610641]
Am J Kidney Dis. 2017 Mar;69(3):e17-e18 [PMID: 28236887]
J Ren Nutr. 2018 Sep;28(5):e37-e40 [PMID: 29706262]
Clin J Am Soc Nephrol. 2013 Sep;8(9):1548-55 [PMID: 23744002]
Cleve Clin J Med. 2018 Aug;85(8):629-638 [PMID: 30102593]
Toxins (Basel). 2025 Jan 26;17(2): [PMID: 39998074]
Int J Mol Sci. 2020 Jul 03;21(13): [PMID: 32635265]
Int J Pharm Pract. 2021 Dec 4;29(6):587-597 [PMID: 34244750]
Nephrology (Carlton). 2012 Jul;17(5):472-9 [PMID: 22435951]
Kidney360. 2021 Mar 26;2(6):1042-1047 [PMID: 35373074]
Kidney Int. 2013 Sep;84(3):622-3 [PMID: 23989362]
J Clin Med. 2023 Aug 09;12(16): [PMID: 37629226]
Nutrients. 2023 Feb 16;15(4): [PMID: 36839360]
Med Access Point Care. 2020 Sep 16;4:2399202620954089 [PMID: 36204091]
Cochrane Database Syst Rev. 2021 Jun 24;6:CD010070 [PMID: 34164803]
BMC Nephrol. 2022 Apr 22;23(1):158 [PMID: 35459131]
Am J Kidney Dis. 2020 Sep;76(3 Suppl 1):S1-S107 [PMID: 32829751]
Can J Cardiol. 2024 Sep;40(9):1718-1728 [PMID: 38458564]
Nephrol Ther. 2019 Jul;15(4):193-200 [PMID: 31126878]
Pharmacy (Basel). 2023 Nov 30;11(6): [PMID: 38133460]
Kidney Int Suppl. 2005 Aug;(97):S95-101 [PMID: 16014108]
Am J Kidney Dis. 2021 Mar;77(3):427-439 [PMID: 33075388]
Kidney Int. 2024 Apr;105(4S):S117-S314 [PMID: 38490803]
Blood Press. 2019 Dec;28(6):358-374 [PMID: 31392910]
Am J Kidney Dis. 2025 Jan;85(1):115-118 [PMID: 39341543]
Clin Exp Nephrol. 2015 Apr;19(2):161-7 [PMID: 25319188]
Nutrients. 2022 Oct 18;14(20): [PMID: 36297050]
Journal Article Review

Word Cloud

Similar Articles

Cited By