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[Protein-energy wasting and nutritional supplementation in chronic hemodialysis].
G Ital Nefrol 2015 Sep-Oct; 32(5)GI

Abstract

Protein Energy Wasting (PEW) is a pathological condition characterized by a progressive reduction of protein and energy stores. PEW has a high prevalence among patients with CKD/ESRD (Chronic Kidney Disease/End Stage Renal Disease) and is closely associated with adverse clinical outcomes and increased rate of hospitalization, complications and mortality. The multifactorial pathogenesis of PEW is complex. A key role is played both by the reduced intake of nutrients and the condition of hypercatabolism/reduced anabolism typical of renal patients. The approach to prevent or treat PEW has several milestones such as reduction of potential risk factors, improvement in lifestyle and correction of any factor related to dialysis. It also needs a periodic assessment of nutritional status by using biochemical markers, body and muscle mass variables, nutritional scores and instrumental methods, aiming for an early diagnosis. In case of reduced protein and energy intake, the administration of nutrients during dialysis, or the use of oral supplements specific for renal patients are the first nutritional interventions recommended. In fact, oral nutritional supplementation represents the most effective nutritional approach to PEW prevention and treatment. It is simple and safe and it has a positive impact on quality of life and survival of haemodialysis patients. In the case of failure of oral supplementation, nutritional support should be enhanced by using intradialytic parenteral nutrition (IDPN). If the patient has difficulty in swallowing or IDPN is insufficient, total enteral nutrition should be considered.

Authors

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Pub Type(s)

Journal Article
Review

Language

ita

PubMed ID

26480252

Citation

Bozzoli, Laura, et al. "[Protein-energy Wasting and Nutritional Supplementation in Chronic Hemodialysis]." Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia, vol. 32, no. 5, 2015.
Bozzoli L, Sabatino A, Regolisti G, et al. [Protein-energy wasting and nutritional supplementation in chronic hemodialysis]. G Ital Nefrol. 2015;32(5).
Bozzoli, L., Sabatino, A., Regolisti, G., Morabito, S., Donadio, C., Cupisti, A., ... Fiaccadori, E. (2015). [Protein-energy wasting and nutritional supplementation in chronic hemodialysis]. Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia, 32(5).
Bozzoli L, et al. [Protein-energy Wasting and Nutritional Supplementation in Chronic Hemodialysis]. G Ital Nefrol. 2015;32(5) PubMed PMID: 26480252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Protein-energy wasting and nutritional supplementation in chronic hemodialysis]. AU - Bozzoli,Laura, AU - Sabatino,Alice, AU - Regolisti,Giuseppe, AU - Morabito,Santo, AU - Donadio,Carlo, AU - Cupisti,Adamasco, AU - Piotti,Giovanni, AU - Fiaccadori,Enrico, PY - 2015/10/20/entrez PY - 2015/10/21/pubmed PY - 2016/12/15/medline JF - Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia JO - G Ital Nefrol VL - 32 IS - 5 N2 - Protein Energy Wasting (PEW) is a pathological condition characterized by a progressive reduction of protein and energy stores. PEW has a high prevalence among patients with CKD/ESRD (Chronic Kidney Disease/End Stage Renal Disease) and is closely associated with adverse clinical outcomes and increased rate of hospitalization, complications and mortality. The multifactorial pathogenesis of PEW is complex. A key role is played both by the reduced intake of nutrients and the condition of hypercatabolism/reduced anabolism typical of renal patients. The approach to prevent or treat PEW has several milestones such as reduction of potential risk factors, improvement in lifestyle and correction of any factor related to dialysis. It also needs a periodic assessment of nutritional status by using biochemical markers, body and muscle mass variables, nutritional scores and instrumental methods, aiming for an early diagnosis. In case of reduced protein and energy intake, the administration of nutrients during dialysis, or the use of oral supplements specific for renal patients are the first nutritional interventions recommended. In fact, oral nutritional supplementation represents the most effective nutritional approach to PEW prevention and treatment. It is simple and safe and it has a positive impact on quality of life and survival of haemodialysis patients. In the case of failure of oral supplementation, nutritional support should be enhanced by using intradialytic parenteral nutrition (IDPN). If the patient has difficulty in swallowing or IDPN is insufficient, total enteral nutrition should be considered. SN - 1724-5990 UR - https://www.unboundmedicine.com/medline/citation/26480252/[Protein_energy_wasting_and_nutritional_supplementation_in_chronic_hemodialysis]_ L2 - https://medlineplus.gov/dialysis.html DB - PRIME DP - Unbound Medicine ER -