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A patient with CKD and poor nutritional status.
Clin J Am Soc Nephrol 2013; 8(12):2174-82CJ

Abstract

Protein energy wasting is common in patients with CKD and ESRD and is associated with adverse clinical outcomes, such as increased rates of hospitalization and death, in these patients. A multitude of factors can affect the nutritional and metabolic status of patients with CKD, including decreased dietary nutrient intake, catabolic effects of renal replacement therapy, systemic inflammation, metabolic and hormonal derangements, and comorbid conditions (such as diabetes and depression). Unique aspects of CKD also confound reliable assessment of nutritional status, further complicating management of this comorbid condition. In patients in whom preventive measures and oral dietary intake from regular meals cannot help them maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is effective in replenishing protein and energy stores. The advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic steroids and exercise, with nutritional supplementation or alone, improve protein stores and represent potential additional approaches for the treatment of PEW. There are several emerging novel therapies, such as appetite stimulants, anti-inflammatory interventions, and anabolic agents.

Authors+Show Affiliations

Department of Medicine, Division of Nephrology, Vanderbilt University School of Medicine, Nashville, Tennessee.

Pub Type(s)

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

Language

eng

PubMed ID

23970134

Citation

Ikizler, T Alp. "A Patient With CKD and Poor Nutritional Status." Clinical Journal of the American Society of Nephrology : CJASN, vol. 8, no. 12, 2013, pp. 2174-82.
Ikizler TA. A patient with CKD and poor nutritional status. Clin J Am Soc Nephrol. 2013;8(12):2174-82.
Ikizler, T. A. (2013). A patient with CKD and poor nutritional status. Clinical Journal of the American Society of Nephrology : CJASN, 8(12), pp. 2174-82. doi:10.2215/CJN.04630513.
Ikizler TA. A Patient With CKD and Poor Nutritional Status. Clin J Am Soc Nephrol. 2013;8(12):2174-82. PubMed PMID: 23970134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A patient with CKD and poor nutritional status. A1 - Ikizler,T Alp, Y1 - 2013/08/22/ PY - 2013/8/24/entrez PY - 2013/8/24/pubmed PY - 2014/8/29/medline SP - 2174 EP - 82 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 8 IS - 12 N2 - Protein energy wasting is common in patients with CKD and ESRD and is associated with adverse clinical outcomes, such as increased rates of hospitalization and death, in these patients. A multitude of factors can affect the nutritional and metabolic status of patients with CKD, including decreased dietary nutrient intake, catabolic effects of renal replacement therapy, systemic inflammation, metabolic and hormonal derangements, and comorbid conditions (such as diabetes and depression). Unique aspects of CKD also confound reliable assessment of nutritional status, further complicating management of this comorbid condition. In patients in whom preventive measures and oral dietary intake from regular meals cannot help them maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is effective in replenishing protein and energy stores. The advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic steroids and exercise, with nutritional supplementation or alone, improve protein stores and represent potential additional approaches for the treatment of PEW. There are several emerging novel therapies, such as appetite stimulants, anti-inflammatory interventions, and anabolic agents. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/23970134/A_patient_with_CKD_and_poor_nutritional_status_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=23970134 DB - PRIME DP - Unbound Medicine ER -