Nutrition and Metabolism in Kidney Disease (original) (raw)
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A REVIEW: NUTRITION IN CHRONIC KIDNEY DISEASE PATIENTS
End-stage renal disease (ESRD) can result from a wide variety of different kidney diseases. Currently, 90% of patients reaching CKD have chronic diabetes mellitus, glomerulonephritis or hypertension. With CKD comes a myriad of problems related to the kidney's inability to excrete waste products leads to symptoms of uraemia. The treatments of CKD require dialysis or kidney transplantation. In this review, an attempt has been made to explain the nutritional management of CKD along with various dialysis treatment and the complications related to the dialysis method. It is important to maintain optimal nutritional status so that the patient will be a good candidate to respond to the treatment effectively.Kidney Patients necessitate following a blanced diet plan to retain normal protein stores and to avoid metabolic complications. This article deals with the therapeutic aspects of nutrition in CKD patients and will improve the quality of life INTRODUCTION The kidney is the human organ basically responsible for the filtration of nitrogenous and other metabolic waste products from the body through the urinary system and maintains the metabolism of biochemical especially haemostatics fluid, electrolyte and acid-base balance. (1)Another key biochemical function of the kidney is to help maintain blood pressure, activate vitamin D and produce erythropoietin. But, the efficiency of the kidney is a decline when there is a loss of nephron function.(2)
Handbook of Famine, Starvation, and Nutrient Deprivation
Malnutrition continues to be a problem in chronic kidney disease (CKD) patients on hemodialysis (HD), resulting in increased morbidity and mortality. Factors that reduce food intake and increase hypercatabolism play important role in malnutrition seen in dialysis patients. Various factors contributing to malnutrition syndrome in dialysis are anorexia due to uremia with electrolyte and hormone imbalances, metabolic abnormalities, gastrointestinal disorders, psychological factors, severe dietary restriction, social problems, increased inflammation, hypercatabolism, and nutrient losses during hemodialysis and peritoneal dialysis. Detecting malnutrition in CKD patients is very challenging. Dialysis patients commonly show protein depletion and energy deficit. The term protein-energy wasting (PEW) syndrome describes the loss of body protein mass and reduction in calorie reserves in dialysis patients. Some dialysis patients can also get overweight or obese and do not appear to have energy deficit but may have protein malnutrition. PEW syndrome is associated with a poor prognosis. The pathogenesis of PEW is incompletely understood and has multifactorial etiopathogenesis. Comorbidities and underdialysis also contribute to anorexia and malnutrition in dialysis. Intra-dialysis hyperalimentation may be provided for patients who continue to lose weight despite oral supplementation (at least 50% or more of the prescribed caloric intake).
Medical Nutrition Therapy in Renal Replacement Therapy
2023
This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy (RRT), outlining the nutrient requirements for patients on maintenance hemodialysis, peritoneal dialysis, and kidney transplant in acute and chronic phases. The chapter takes note of the drastic impact of RRT on the patient's nutrition status and overall well-being, which puts them at high risk of morbidity and mortality, and thus emphasizes timely and regular comprehensive nutrition assessment to enable appropriate intervention. Recognizing that there are different modalities of RRT and that patients have different physiological characteristics as well as different laboratory test values, which may also vary for individual patients each time tests are run, nutrition therapy is individualized each time. The chapter takes a closer look at protein-energy wasting, a condition common among patients undergoing RRT, which is a predictor of mortality, discussing its prevention and treatment measures. Finally, the chapter takes a closer look at electrolytes, specifically potassium, sodium, calcium, and phosphorous, in relation to mineral bone disease.
American Journal of Kidney Diseases, 1995
0 Although malnutrition is not uncommon in continuous ambulatory peritoneal dialysis (CAPD) and maintenance hemodialysis (MHD) patients, there has never been a large-scale comparison study of nutritional status wlth these two dialysis modalities. We therefore assessed protein-calorie nutrition in 224 CAPD patients and 263 MHD patients who were treated in eight centers in ltaly. The CAPD patients were slightly older than the MHD patients (60.2 + 14.2 years v 56.3 2 15.1 years; P < O.Ol), had undergone dialysis for less time (2.32 2 2.10 years v 3.66 ? 2.66 years; P < O.ooOl), and had higher residual renal function (1.63 2 2.29 mUmin v 0.27 2 0.91 mUmin; P < 0.0001). Protein nitrogen appearance was 60.5 + 16.6 g/d and 61.9 + 16.5 g/d in the CAPD and MHD patients, respectively. In CAPD versus MHD patients, serum total protein and albumin tended to be lower; serum transfenin and midarm muscle circumference were similar; and relative body weight, skinfold thickness, and estimated percent body fat tended to be greater. These greater values in CAPD patients were particularly evident in those who were 65 years of age or older. Serum glucose, total cholesterol, and triglycerides also were greater in CAPD patients. The subjective global nutritional assessment indicated a significantly greater proportion of malnourished CAPD patients than MHD patients (42.3% v 30.6%). The greater prevalence of malnutrition in CAPD patients diminished wlth age. Maintenance hemodialysis patients older than 76 years were more likely to be malnourished than CAPD Patients. In patients less than 65 years of age, protein-calorie malnutrltion was more likely to be present in CAPD patients than in MHD patients. 0 1995 by the National Kidney Foundation, Inc.
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...
Journal of Evolution of medical and Dental Sciences, 2015
BACKGROUND: CKD is one of the leading cause morbidity and mortality worldwide Incidence of chronic kidney disease is raising which is likely to pose major problems for both health care and the economy of future years in India. Dialysis is a form of renal replacement therapy for severe kidney failure. Malnutrition is one of the common complications in patients with end stage renal disease undergoing hemodialysis. AIM: The present study is aimed to evaluate role of albumin and other biochemical parameters predicting malnutrition in CKD patients undergoing hemodialysis. MATERIAL AND METHODS: A group of 15 normal healthy subjects (control group) and 30 CKD patients on hemodialysis (test group) were enrolled in this study. Albumin, urea, creatinine, total cholesterol and CRP were estimated in serum sample collected from normal and CKD-HD subjects. RESULTS: Results were expressed as mean ±SD, student ‘t’ test applied and ‘p’ value was calculated ‘p’ value <0.005 was considered as stati...