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HOW TO PREVENT PROTEIN-ENERGY WASTING IN PATIENTS WITH CHRONIC KIDNEY DISEASE – POSITION STATEMENT OF THE CROATIAN SOCIETY OF NEPHROLOGY, DIALYSIS AND TRANSPLANTATION
NIKOLINA BAŠIĆ-JUKIĆ
orcid.org/0000-0002-0221-2758
; Klinički bolnički centar Zagreb, Zavod za nefrologiju, arterijsku hipertenziju, dijalizu i transplantaciju, Zagreb, Hrvatska
SANJIN RAČKI
; Klinički bolnički centar Rijeka, Zavod za nefrologiju i dijalizu, Rijeka, Hrvatska
PETAR KES
; Klinički bolnički centar Zagreb, Zavod za nefrologiju, arterijsku hipertenziju, dijalizu i transplantaciju, Zagreb, Hrvatska
DRAGAN LJUTIĆ
; Klinički bolnički centar Split, Zavod za nefrologiju, Split, Hrvatska
BOŽIDAR VUJIČIĆ
; Klinički bolnički centar Rijeka, Zavod za nefrologiju i dijalizu, Rijeka, Hrvatska
VESNA LOVČIĆ
; Opća bolnica Bjelovar, Odjel za neurologiju, Bjelovar, Hrvatska
LIDIJA ORLIĆ
; Klinički bolnički centar Rijeka, Zavod za nefrologiju i dijalizu, Rijeka, Hrvatska
INGRID PRKAČIN
; Klinička bolnica Merkur, Zavod za hitnu medicinu, Zagreb, Hrvatska
JOSIPA RADIĆ
; Klinički bolnički centar Split, Zavod za nefrologiju, Split, Hrvatska
MARKO JAKIĆ
; Klinički bolnički centar Osijek, Zavod za nefrologiju, Osijek, Hrvatska
DRAGAN KLARIĆ
; Opća bolnica Zadar, Odjel za nefrologiju, Zadar, Hrvatska
MARIJANA GULIN
; Opća bolnica Šibemik, Odjel za nefrologiju, Šibenik, Hrvatska
Sažetak
Protein-energy wasting (PEW) is a frequent problem in patients with end-stage renal disease, which is associated with adverse outcome. Risk factors for development of PEW in dialysis patients include anorexia, limitations in food intake due to problems with mineral metabolism (hyperphosphatemia, hyperkalemia). Prevention of PEW in dialysis population demands different therapeutic measures to correct abnormalities and to prevent loss of energy and proteins. Therapeutic approach should be individualized based on the specific problems of each patient in order to correct metabolic problems and to optimize food intake. In patients with inability to maintain nutritional status with standard oral feeding, other measures which include oral nutrition supplements and intradialytic parenteral feeding should be applied. Anabolic steroids, growth hormone and adequate oral nutritional supplements, together with physical activity may prevent further catabolism and correct abnormalities. Appetite stimulators, antiinflammatory interventions and anabolic drugs seem promising; however, their efficacy should be investigated in future clinical trials.
Ključne riječi
nutrition; dialysis; protein-energy wasting; oral dietary supplements
Hrčak ID:
126813
URI
Datum izdavanja:
14.9.2014.
Posjeta: 2.721 *