Nutritional management of pregnancy in chronic kidney disease.

The nutritional management of pregnant adults with chronic kidney disease (CKD) presents the challenge of combining necessary modifications in nutrient requirements for both pregnancy and kidney impairment. The dietitian must follow these women closely to ensure adequate intakes of kilocalories, protein, and specific vitamins and minerals. Combining the suggested energy and protein needs for CKD recommended by the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines with those for the general population seems feasible during pregnancy. Vitamin and mineral requirements are also a combination of those for CKD and pregnancy. Although diets may need to be restricted because of CKD, goals are to have good communication among members of the health-care team to allow the patient optimal nutrition combined with quality medical care.