Renal-diabetes nutrition: bridging the gap between dietary guidelines and patient experiences

Chronic kidney disease (CKD) and diabetes mellitus (DM) often coexist and pose distinctive dietary difficulties for patients. While CKD recommendations underscore nutrient limitations, specifically for potassium and phosphate, diabetes dietary guidelines highlight balanced carbohydrate consumption, and increased intake of fruit and vegetables. These interrelating yet conflicting needs cause stress and confusion among patients, often resulting in poor dietary compliance. Advances in renal nutrition recommendations promote a more flexible and personalized approach, identifying the lower bioavailability of potassium in whole foods and the substantial contribution of food additives to nutrient surplus. These advances enable higher compliance with diabetes dietary principles and support plant- based approaches that enhance both glycaemic and renal outcomes. Nonetheless, dietary management remains disintegrated, with renal and diabetes dietitians usually working independently, since there is no integrated training pathway for dietitians to obtain dual expertise. A multidisciplinary approach is crucial, and training individual dietitians with unified proficiencies could rationalize care, reduce patient confusion and improve patient outcomes. This review delves into the clinical evolution of renal-diabetes dietary guidance, patient experiences, and the urgent need for cohesive and collective dietetic care.