Ms Leelynn Tew1, Prof Anna Rangan1,2, Prof Gopi Rangan3, Ms Vanessa Cullen4, Ms Amy Luchterhand4, Dr Jessica Dawson5,6
1Nutrition and Dietetics Discipline, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney., Sydney, Australia, 2Charles Perkins Centre, Sydney Nursing School. Faculty of Medicine and Health, University of Sydney., Sydney, Australia, 3Michael Stern Laboratory for Polycystic Kidney Disease, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Australia, Sydney, Australia, 4PKD Australia, Roseville, New South Wales, Australia, Sydney, Australia, 5NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia , Sydney, Australia, 6Dept of Nutrition and Dietetics, St George Hospital, Sydney, New South Wales, Australia, Sydney, Australia
Biography:
Jess is an Advanced Accredited Practicing Dietitian. She completed her PhD in 2021 evaluating the impact of digital interventions in chronic kidney disease. She is passionate about making dietary counselling accessible and empowering people to make dietary change to improve their health.
Aims:
To describe renal healthcare professionals’ (HCPs) practices and perspectives on diet and fluid management for autosomal-dominant polycystic kidney disease (ADPKD).
Background:
Dietary management is a high priority to the ADPKD community, with increasing interest in targeted diet therapies that may address pathophysiological causes of ADPKD. Current dietary practices and recommendations, and perceptions of novel diet therapies for diet and fluid management of renal HCP have not been described.
Methods:
A 41-item online survey was distributed across renal HCP networks from August–September 2024. The survey combined closed/open-ended and ranking questions to assess current practices and novel diet perceptions among multidisciplinary renal HCPs.
Results:
Among 95 respondents (nephrologists 35%, dietitians 35%, nurses 29%, other 2%) management of sodium, fluid and dietary quality were top priorities, with protein gaining emphasis as ADPKD progressed. Most HCP recommended dietary interventions for uncontrolled comorbidities (e.g., hypertension, nephrolithiasis) (70%), prevention of ADPKD progression (61%), or declining kidney function (52%). Less than 10% of respondents reported not recommending dietary interventions at any stage of ADPKD. Novel diets were not routinely recommended by respondents. Plant-based diets (48%) and caloric restriction (31%) were the most likely to be recommended, whilst few respondents were likely to recommend ketogenic diets (7%), intermittent fasting (13%) and time restricted feeding (14%). Key barriers included limited evidence and implementation challenges, while potential benefits of these diets included slowing disease progression and improving metabolic health.
Conclusions:
HCPs align ADPKD dietary guidance with general CKD principles, prioritizing hydration and comorbidity management. Novel diets like ketogenic face scepticism due to insufficient evidence and practicality concerns. Clinical trials are needed to clarify their role in ADPKD care and support evidence-based recommendations.