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Chronic Kidney Disease and Nutrition Support.
Nutr Clin Pract. 2021 Apr; 36(2):312-330.NC

Abstract

Individuals with chronic kidney disease (CKD), particularly those undergoing maintenance dialysis, are prone to protein-energy wasting (PEW), the latter of which can be ameliorated with different methods of nutrition support. Dietary counseling guided by dietitians is the key for preventing and managing PEW in CKD. If dietary counseling per se fails to meet the recommended energy and protein requirements, the addition of oral nutrition supplements (ONSs) would be necessary. When these initial measures cannot attain the recommended energy and protein requirements, nutrition support, including enteral tube feeding or parenteral nutrition (PN), should be considered as a viable option to improve nutrition status. Partial PN, comprising intraperitoneal PN (IPPN) and intradialytic PN (IDPN) therapies, may be attempted as supplemental nutrition support in patients with PEW requiring peritoneal dialysis and hemodialysis, respectively. Despite the debatable effectiveness of IPPN for patients undergoing peritoneal dialysis, it remains a feasible means in these patients. The indications for IPPN in patients undergoing peritoneal dialysis include inadequate dietary intake of energy and protein, and barriers of oral intake and other forms of enteral supplementation such as issues with suitability, tolerance, and compliance. Nonetheless, in the case of spontaneous dietary consumption of energy and protein meeting the difference between the IDPN provision and the nutrition targets, the use of IDPN is rational. In patients with PEW and malfunctioning gastrointestinal tract, as well as those whose enteral intake (with or without partial PN) is below the recommended nutrient requirements, total PN becomes a relevant nutrition intervention.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Chan W
School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham, Edgbaston, Birmingham, United Kingdom. Department of Nephrology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, United Kingdom.

MeSH

HumansKidney Failure, ChronicNutritional SupportProtein-Energy MalnutritionRenal DialysisRenal Insufficiency, Chronic

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33734473

Citation

Chan, Winnie. "Chronic Kidney Disease and Nutrition Support." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 36, no. 2, 2021, pp. 312-330.
Chan W. Chronic Kidney Disease and Nutrition Support. Nutr Clin Pract. 2021;36(2):312-330.
Chan, W. (2021). Chronic Kidney Disease and Nutrition Support. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 36(2), 312-330. https://doi.org/10.1002/ncp.10658
Chan W. Chronic Kidney Disease and Nutrition Support. Nutr Clin Pract. 2021;36(2):312-330. PubMed PMID: 33734473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Kidney Disease and Nutrition Support. A1 - Chan,Winnie, Y1 - 2021/03/18/ PY - 2021/3/19/pubmed PY - 2021/9/1/medline PY - 2021/3/18/entrez KW - chronic kidney disease KW - energy KW - enteral nutrition KW - nutrition requirements KW - nutrition support KW - parenteral nutrition KW - protein SP - 312 EP - 330 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 36 IS - 2 N2 - Individuals with chronic kidney disease (CKD), particularly those undergoing maintenance dialysis, are prone to protein-energy wasting (PEW), the latter of which can be ameliorated with different methods of nutrition support. Dietary counseling guided by dietitians is the key for preventing and managing PEW in CKD. If dietary counseling per se fails to meet the recommended energy and protein requirements, the addition of oral nutrition supplements (ONSs) would be necessary. When these initial measures cannot attain the recommended energy and protein requirements, nutrition support, including enteral tube feeding or parenteral nutrition (PN), should be considered as a viable option to improve nutrition status. Partial PN, comprising intraperitoneal PN (IPPN) and intradialytic PN (IDPN) therapies, may be attempted as supplemental nutrition support in patients with PEW requiring peritoneal dialysis and hemodialysis, respectively. Despite the debatable effectiveness of IPPN for patients undergoing peritoneal dialysis, it remains a feasible means in these patients. The indications for IPPN in patients undergoing peritoneal dialysis include inadequate dietary intake of energy and protein, and barriers of oral intake and other forms of enteral supplementation such as issues with suitability, tolerance, and compliance. Nonetheless, in the case of spontaneous dietary consumption of energy and protein meeting the difference between the IDPN provision and the nutrition targets, the use of IDPN is rational. In patients with PEW and malfunctioning gastrointestinal tract, as well as those whose enteral intake (with or without partial PN) is below the recommended nutrient requirements, total PN becomes a relevant nutrition intervention. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/33734473/Chronic_Kidney_Disease_and_Nutrition_Support_ DB - PRIME DP - Unbound Medicine ER -