A REVIEW: NUTRITION IN CHRONIC KIDNEY DISEASE PATIENTS (original) (raw)
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Bioscientia Medicina : Journal of Biomedicine and Translational Research
The need for proper nutrition and diet is fundamental in every stage of chronic kidney disease. The principle of nutritional therapy is slowing the progression of chronic kidney disease, delaying patients with CKD (chronic kidney disease) from getting kidney replacement therapy. In CKD patients, there is a disturbance of protein homeostasis, disturbance in metabolism protein, acid-base disorders, and hormonal dysfunctions. As the progression of CKD increases, nitrogen-containing products accumulate, causing a decrease in appetite. In CKD patients, intestinal absorption is also impaired because uremia causes microbiota disturbance and damage to the intestinal epithelium. These various things cause nutritional status to become often irregular, and protein energy wasting frequently occurs, thus requiring dietary adjustments in patients with CKD. In conclusion, each individual with CKD has a different nutritional therapy approach depending on the disease conditions and nutritional statu...
Nutrition and Metabolism in Kidney Disease
Seminars in Nephrology, 2006
Nutritional and metabolic derangements are highly prevalent in patients with chronic kidney disease (CKD) and patients on renal replacement therapy. These derangements, which can be termed uremic malnutrition, significantly affect the high morbidity and mortality rates observed in this patient population. Uremic malnutrition clearly is related to multiple factors encountered during the predialysis stage and during chronic dialysis therapy. Several preliminary studies suggested that interventions to improve the nutritional status and metabolic status of uremic patients actually may improve the expected outcome in these patients, although their long-term efficacy is not well established. It therefore is important to emphasize that uremic malnutrition is a major comorbid condition in CKD and renal replacement therapy patients, and that all efforts should be made to try to understand better and treat these conditions effectively to improve not only mortality but also the quality of life of chronically uremic patients. In this article we review the current state of knowledge in the field of nutrition and metabolism in all stages of CKD and renal replacement therapy, including kidney transplant. We also address questions that face investigators in this field and suggest where future research might be headed.
Nutritional treatment of advanced CKD: twenty consensus statements
Journal of nephrology, 2018
The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, e...
Nephrology @ Point of Care
This is a case report on a patient with non-dialysis chronic kidney disease (CKD) in whom several nutritional issues are briefly discussed from a practical point of view. The article is accompanied by an editorial published in this Journal in relation to the 2nd International Conference of the European Renal Nutrition working group at ERA-EDTA—“Retarding CKD progression: readily available through comprehensive nutritional management?”— and focuses on several practical topics associated with the nutritional approach for the conservative treatment of non-dialysis CKD. The article is divided into 3 sections—basic nutritional assessment, nutritional targets, and nutritional follow-up in non-dialysis CKD—linked to 3 consecutive steps of the clinical follow-up of the patient and the related nutritional concerns and intervention. First visit: Baseline nutritional assessment and basic nutritional considerations in non-dialysis chronic kidney disease (CKD) • What nutritional assessment/monit...
A CROSS SECTIONAL STUDY OF NUTRITIONAL ASSESSMENT IN CHRONIC KIDNEY DISEASE PATIENTS.
Background: Chronic kidney disease is one of the global burdens, more so in developing countries where the medical facility is not abundantly available in the rural areas. Along with comorbid conditions, protein energy malnutrition plays a vital role in progression of renal disease. Proper diet management can decrease the rapid progression of chronic kidney disease. Though many studies have been done in other countries regarding the nutritional assessment in chronic kidney disease patients, it is mandatory to assess the prevalence of malnutrition in the rural or urban population of developing country. Methods: 100 consecutive patients were enrolled for the study. After obtaining written consent, history regarding the demographic data, duration of the disease, associated clinical features and 24 hour dietary recall were obtained. Then basic anthropometric parameters such as height, weight, Body Mass Index, skin fold thickness and mid arm circumference was measured. Later laboratory parameters such as haemoglobin, serum urea, serum creatinine, calcium, phosphorus, uric acid, total protein and serum albumin was measure. Results: The prevalence of protein energy malnutrition is 36% in our study which is more prevalent in the male gender as the total number of male patients are predominant in our study. And the patients in the initial stages of CKD are not aware of low protein diet. It is advisable to introduce dietary management along with medical management in all stages of chronic kidney disease patients. Conclusion: The incidence of PEM among the study population is nearly high but proper nutritional knowledge is lacking in these patients. Hence it is mandatory to introduce dietary management along with medical management in all stages of CKD so that rapid progression to end stage renal disease can be delayed.. It is also identified that severe protein energy malnutrition itself increases the mortlity of the patients. Small population, unequal gender and age distribution, shorter time period and unavailability of data for stage 1 CKD were the major limitations of the study. Hence in the future rectifying all the above said limitations such a study has to repeated periodically for better understanding of the study which will further improve the patient care and may help in reducing the early progression of the kidney disease.a large randomised control study can throw mucy light in the management of PEM in CKD patients.
Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease
Nutrients
Chronic kidney disease affects ≈37 million adults in the US, and it is often undiagnosed due to a lack of apparent symptoms in early stages. Chronic kidney disease (CKD) interferes with the body’s physiological and biological mechanisms, such as fluid electrolyte and pH balance, blood pressure regulation, excretion of toxins and waste, vitamin D metabolism, and hormonal regulation. Many CKD patients are at risk of hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone deterioration, blood pressure abnormalities, and edema. These risks may be minimized, and the disease’s progression may be slowed through careful monitoring of protein, phosphorus, potassium, sodium, and calcium, relieving symptoms experienced by CKD patients. In this review, the current Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations are highlighted, reflecting the 2020 update, including explanations for the pathophysiology behind the recommendations. The Dietary Approaches to Stop Hypert...
Evaluation of Nutritional Status of Chronic Kidney Disease Patients Undergoing Hemodialysis
Med Phoenix, 2020
Background: Chronic kidney disease caused by deterioration of renal function is a growing problem in the world. In chronic kidney disease, renal function is decreased and waste can build to high level in blood. Malnutrition is common in chronic kidney disease patient who is related to poor food intake because of anorexia, restricted protein intake, nausea and vomiting. Objective: This study aims to assess the nutritional status of chronic kidney patients undergoing hemodialysis by anthropometric measurement and laboratory investigations. Materials and Methods: A cross-sectional study was conducted in Human Organ Transplant Center, Bhaktapur, Nepal over a period of 3 months (December, 2016 to February, 2017). Total of 53 patients (25 male and 28 female) undergoing hemodialysis were included in this study. Anthropometric measurements like body mass index, midupper arm circumference and laboratory investigation like serum albumin was used to evaluate the nutritional status of chronic k...