Joint International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) practice recommendation on nutrition management in peritoneal dialysis

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-nephrologist physicians, dietitians, nurses and multidisciplinary care teams for implementation in individuals receiving PD to optimise their nutrition status, prevent and manage protein-energy wasting, 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 five 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.