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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
; Zagreb University Hospital Center, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
SANJIN RAČKI
; Rijeka University Hospital Center, Department of Nephrology and Dialysis, Rijeka, Croatia
PETAR KES
; Zagreb University Hospital Center, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
DRAGAN LJUTIĆ
; Split University Hospital Center, Department of Nephrology, Split, Croatia
BOŽIDAR VUJIČIĆ
; Rijeka University Hospital Center, Department of Nephrology and Dialysis, Rijeka, Croatia
VESNA LOVČIĆ
; Bjelovar General Hospital, Department of Nephrology, Bjelovar, Croatia
LIDIJA ORLIĆ
; Rijeka University Hospital Center, Department of Nephrology and Dialysis, Rijeka, Croatia
INGRID PRKAČIN
; Merkur University Hospital, Department of Intensive Care, Zagreb, Croatia
JOSIPA RADIĆ
; Split University Hospital Center, Department of Nephrology, Split, Croatia
MARKO JAKIĆ
; Osijek University Hospital Center, Department of Nephrology, Osijek, Croatia
DRAGAN KLARIĆ
; Zadar General Hospital, Department of Nephrology, Zadar, Croatia
MARIJANA GULIN
; Šibenik General Hospital, Department of Nephrology, Šibenik, Croatia
Abstract
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.
Keywords
nutrition; dialysis; protein-energy wasting; oral dietary supplements
Hrčak ID:
126813
URI
Publication date:
14.9.2014.
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