Tags

Type your tag names separated by a space and hit enter

Dietary protein and nutritional supplements in conventional hemodialysis.
Semin Dial 2018; 31(6):583-591SD

Abstract

Protein energy wasting (PEW) is a condition commonly occurring among patients with ESRD on hemodialysis. PEW is characterized by depletion of protein and energy stores and is caused by multiple factors related to chronic kidney disease, acute and chronic comorbidities and by renal replacement therapy itself. Anorexia is central in the pathogenesis of PEW; it is frequently observed in these patients whose protein and energy intakes are typically lower than guidelines recommendations. If untreated, PEW invariably leads to major complications, and may activate a vicious circle with further worsening of nutritional status. Dietary counseling and nutritional status monitoring play a key role in the prevention and treatment of PEW, since they allow an early identification of high risk patients, as well as the assessment of the response to nutritional intervention. Different nutritional approaches can be implemented following thorough nutritional counseling. These are chosen on the basis of patients' spontaneous dietary intake, severity of PEW and acute comorbidities. Initially, regular encounters with the dietitian allow patients to clarify doubts and strengthen basic concepts on nutrition to improve dietary intake and prevent PEW. When PEW is present or the patient is at high risk, the clinician may opt for the administration of oral intradialytic or daily supplements, aiming at increasing energy and protein intake, while in selected cases intradialytic parenteral nutrition may be used. This review addresses the main issues of nutritional status in ESRD patients on hemodialysis-its evaluation and monitoring, as well as at describing the available nutritional interventions.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy.Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy.Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy.Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy.University Hospital Maastricht, Maastricht, the Netherlands.Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy. Postgraduate School of Nephrology, University of Parma, Parma, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29909606

Citation

Sabatino, Alice, et al. "Dietary Protein and Nutritional Supplements in Conventional Hemodialysis." Seminars in Dialysis, vol. 31, no. 6, 2018, pp. 583-591.
Sabatino A, Piotti G, Cosola C, et al. Dietary protein and nutritional supplements in conventional hemodialysis. Semin Dial. 2018;31(6):583-591.
Sabatino, A., Piotti, G., Cosola, C., Gandolfini, I., Kooman, J. P., & Fiaccadori, E. (2018). Dietary protein and nutritional supplements in conventional hemodialysis. Seminars in Dialysis, 31(6), pp. 583-591. doi:10.1111/sdi.12730.
Sabatino A, et al. Dietary Protein and Nutritional Supplements in Conventional Hemodialysis. Semin Dial. 2018;31(6):583-591. PubMed PMID: 29909606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary protein and nutritional supplements in conventional hemodialysis. AU - Sabatino,Alice, AU - Piotti,Giovanni, AU - Cosola,Carmela, AU - Gandolfini,Ilaria, AU - Kooman,Jeroen P, AU - Fiaccadori,Enrico, Y1 - 2018/06/17/ PY - 2018/6/18/pubmed PY - 2019/5/29/medline PY - 2018/6/18/entrez KW - end-stage renal disease KW - hemodialysis KW - malnutrition KW - nutrient intake KW - nutritional status KW - protein energy wasting SP - 583 EP - 591 JF - Seminars in dialysis JO - Semin Dial VL - 31 IS - 6 N2 - Protein energy wasting (PEW) is a condition commonly occurring among patients with ESRD on hemodialysis. PEW is characterized by depletion of protein and energy stores and is caused by multiple factors related to chronic kidney disease, acute and chronic comorbidities and by renal replacement therapy itself. Anorexia is central in the pathogenesis of PEW; it is frequently observed in these patients whose protein and energy intakes are typically lower than guidelines recommendations. If untreated, PEW invariably leads to major complications, and may activate a vicious circle with further worsening of nutritional status. Dietary counseling and nutritional status monitoring play a key role in the prevention and treatment of PEW, since they allow an early identification of high risk patients, as well as the assessment of the response to nutritional intervention. Different nutritional approaches can be implemented following thorough nutritional counseling. These are chosen on the basis of patients' spontaneous dietary intake, severity of PEW and acute comorbidities. Initially, regular encounters with the dietitian allow patients to clarify doubts and strengthen basic concepts on nutrition to improve dietary intake and prevent PEW. When PEW is present or the patient is at high risk, the clinician may opt for the administration of oral intradialytic or daily supplements, aiming at increasing energy and protein intake, while in selected cases intradialytic parenteral nutrition may be used. This review addresses the main issues of nutritional status in ESRD patients on hemodialysis-its evaluation and monitoring, as well as at describing the available nutritional interventions. SN - 1525-139X UR - https://www.unboundmedicine.com/medline/citation/29909606/Dietary_protein_and_nutritional_supplements_in_conventional_hemodialysis_ L2 - https://doi.org/10.1111/sdi.12730 DB - PRIME DP - Unbound Medicine ER -