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A patient with CKD and poor nutritional status.
1Department of Medicine, Division of Nephrology, Vanderbilt University School of Medicine, Nashville, Tennessee.
Clinical Journal of the American Society of Nephrology : CJASN
|August 24, 2013
Summary
Protein energy wasting (PEW) in kidney disease patients leads to poor outcomes. Nutritional supplementation and emerging therapies can help replenish protein and energy stores, improving patient health.
Area of Science:
- Nephrology
- Clinical Nutrition
Background:
- Protein energy wasting (PEW) is prevalent in Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD).
- PEW is linked to adverse clinical outcomes, including higher hospitalization and mortality rates in these patients.
- Multiple factors contribute to nutritional status decline in CKD, including reduced intake, inflammation, and metabolic derangements.
Observation:
- Assessing nutritional status in CKD patients is challenging due to unique disease aspects.
- Standard dietary interventions may be insufficient for some patients.
- Nutritional supplementation (oral, enteral, parenteral) is effective for replenishing protein and energy.
Findings:
- Oral nutritional supplements offer proven efficacy, safety, and compliance.
- Anabolic steroids and exercise, with or without nutritional support, can improve protein stores.
- Novel therapies like appetite stimulants and anti-inflammatory agents show promise.
Implications:
- Optimizing nutritional status is crucial for managing CKD and ESRD patients.
- Nutritional supplementation is a cornerstone therapy for PEW.
- Emerging treatments offer new avenues for addressing PEW in kidney disease.
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