International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 171-181 http://medscipublisher.com/index.php/ijccr 173 3 Individualized Diet Plans 3.1 Nutritional support for different CKD stages The dietary plan for CKD patients should be formulated according to the different stages of the disease. As kidney function declines, the body's nutritional requirements and potential risks will also change accordingly. In the early stage, it is mainly necessary to adjust the intake of protein and it is recommended to adopt a healthy diet (such as the Mediterranean diet or plant-based diet) to slow down the progression of the disease and control complications (Chauveau et al., 2018; Kalantar-Zadeh et al., 2020). In the middle and late stages, the intake of protein, sodium, potassium and phosphorus needs to be more strictly controlled and adjusted according to the specific situation of each patient to prevent malnutrition and avoid problems such as hyperkalemia and hyperphosphatemia (Ikizler et al., 2020; Kim and Jung, 2020; Narasaki et al., 2024). Personalized nutrition plans that take into account patients' genes, physical conditions, other diseases, and social and cultural preferences are increasingly regarded as a necessary approach to achieving better results and enabling patients to adhere longer (Figure 1) (Narasaki et al., 2024; Pradhan et al., 2025). Patient-centered intervention methods led by nutritionists, such as plant-based low-protein diets (PLADO), show promising prospects in improving quality of life, delaying dialysis time and reducing the risk of cardiovascular diseases (Kalantar-Zadeh et al., 2020; Padial et al., 2024). From no need for dialysis to need dialysis, the diet also needs to be dynamically adjusted to adapt to the constantly changing metabolic requirements and avoid protein-energy expenditure. Figure 1 Nutritional management in advanced CKD (Adopted from Narasaki et al., 2024) Image caption: CKD, chronic kidney disease; EAA, essential amino acids; GI, gastrointestinal; KA, ketogenic amino acids; MUFA, monounsaturated fatty acid; PLADO, plant-dominant low-protein diet; PUFA, polyunsaturated fatty acids; SFA, saturated fatty acids (Adopted from Narasaki et al., 2024) 3.2 Principles for controlling the intake of protein, sodium, potassium and Phosphorus For patients with chronic kidney disease who have not received dialysis, the protein intake is usually maintained at 0.6 to 0.8 grams per kilogram of body weight per day. This helps to reduce the production of nitrogenous waste, delay the progression of the disease, and giving priority to plant protein can lower the risks related to heart and metabolism (Alobaidi, 2025). It is recommended to limit sodium intake (less than 2.3 grams per day) to manage blood pressure and prevent fluid retention. The intake of potassium needs to be adjusted according to the blood potassium level to prevent hyperkalemia or hypokalemia (Ko et al., 2017; Kim and Jung, 2020). Limiting phosphorus intake is of vital importance, especially in the advanced stage of CKD. The key point is to reduce
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