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

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).