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Nutrition support for the chronically wasted or acutely catabolic chronic kidney disease patient.
Semin Nephrol 2009; 29(1):75-84SN

Abstract

Because of the number of factors affecting the nutritional and metabolic status in patients with advanced chronic kidney disease or who are on maintenance dialysis, the prevention and treatment of protein-energy wasting (PEW) of chronic kidney disease should involve a comprehensive combination of maneuvers to diminish protein and energy depletion, in addition to therapies that will avoid further losses. The available evidence suggests that nutritional supplementation, administered orally or parenterally, is effective in the treatment of maintenance dialysis patients with PEW in whom oral dietary intake from regular meals cannot maintain adequate nutritional status. Increased oral nutrient intake during dialysis and at home is the ideal choice for this intervention. In clinical practice, the advantages of intradialytic oral nutritional supplements include proven efficacy and compliance. Therefore, at a minimum, oral nutritional supplementation given intradialytically should be attempted in maintenance dialysis patients with PEW, accompanied by individualized dietary advice for appropriate intake at home. In ones who cannot tolerate oral feeding, other forms of nutritional supplementation including intradialytic parenteral nutritional are a reasonable strategy. Although not proven conclusively, nutritional interventions in the form of supplementation may lead to considerable improvements in mortality, hospitalization, and treatment costs.

Authors+Show Affiliations

Department of Medicine, Division of Nephrology, Vanderbilt University School of Medicine, Nashville, TN 37232-2372, USA. alp.ikizler@vanderbilt.edu

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19121477

Citation

Ikizler, T Alp. "Nutrition Support for the Chronically Wasted or Acutely Catabolic Chronic Kidney Disease Patient." Seminars in Nephrology, vol. 29, no. 1, 2009, pp. 75-84.
Ikizler TA. Nutrition support for the chronically wasted or acutely catabolic chronic kidney disease patient. Semin Nephrol. 2009;29(1):75-84.
Ikizler, T. A. (2009). Nutrition support for the chronically wasted or acutely catabolic chronic kidney disease patient. Seminars in Nephrology, 29(1), pp. 75-84. doi:10.1016/j.semnephrol.2008.10.011.
Ikizler TA. Nutrition Support for the Chronically Wasted or Acutely Catabolic Chronic Kidney Disease Patient. Semin Nephrol. 2009;29(1):75-84. PubMed PMID: 19121477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition support for the chronically wasted or acutely catabolic chronic kidney disease patient. A1 - Ikizler,T Alp, PY - 2009/1/6/entrez PY - 2009/1/6/pubmed PY - 2009/4/30/medline SP - 75 EP - 84 JF - Seminars in nephrology JO - Semin. Nephrol. VL - 29 IS - 1 N2 - Because of the number of factors affecting the nutritional and metabolic status in patients with advanced chronic kidney disease or who are on maintenance dialysis, the prevention and treatment of protein-energy wasting (PEW) of chronic kidney disease should involve a comprehensive combination of maneuvers to diminish protein and energy depletion, in addition to therapies that will avoid further losses. The available evidence suggests that nutritional supplementation, administered orally or parenterally, is effective in the treatment of maintenance dialysis patients with PEW in whom oral dietary intake from regular meals cannot maintain adequate nutritional status. Increased oral nutrient intake during dialysis and at home is the ideal choice for this intervention. In clinical practice, the advantages of intradialytic oral nutritional supplements include proven efficacy and compliance. Therefore, at a minimum, oral nutritional supplementation given intradialytically should be attempted in maintenance dialysis patients with PEW, accompanied by individualized dietary advice for appropriate intake at home. In ones who cannot tolerate oral feeding, other forms of nutritional supplementation including intradialytic parenteral nutritional are a reasonable strategy. Although not proven conclusively, nutritional interventions in the form of supplementation may lead to considerable improvements in mortality, hospitalization, and treatment costs. SN - 0270-9295 UR - https://www.unboundmedicine.com/medline/citation/19121477/Nutrition_support_for_the_chronically_wasted_or_acutely_catabolic_chronic_kidney_disease_patient_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270-9295(08)00173-3 DB - PRIME DP - Unbound Medicine ER -