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Nutritional status and the risk of malnutrition in older adults with chronic kidney disease- implications for low protein intake and nutritional care : A critical review endorsed by ERN-ERA and ESPEN
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- Piccoli, Giorgina Barbara (författare)
- Ctr Hosp Le Mans, Nephrol & Dialyse, Ave Rubillard, F-72037 Le Mans, France.
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- Cederholm, Tommy (författare)
- Karolinska Institutet,Uppsala universitet,Klinisk nutrition och metabolism,Theme Inflammation & Aging, Karolinska University Hospital, Stockholm, Sweden
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- Avesani, Carla Maria (författare)
- Karolinska Institutet
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- Bakker, Stephan J. L. (författare)
- Univ Med Ctr Groningen, Dept Internal Med, Div Nephrol, Groningen, Netherlands.
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- Bellizzi, Vincenzo (författare)
- Hosp Sant Anna & San Sebastiano, Dept Med Sci, Nephrol & Dialysis Div, Caserta, Italy.
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- Cuerda, Cristina (författare)
- Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Dept Med, Nutr Unit, Madrid, Spain.
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- Cupisti, Adamasco (författare)
- Univ Pisa, Dept Clin & Expt Med, Via Roma 67, I-56126 Pisa, Italy.
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- Sabatino, Alice (författare)
- Azienda Osped Univ Parma, UO Nefrol, Parma, Italy.
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- Schneider, Stephane (författare)
- Univ Cote Azur, Nice Univ Hosp, Gastroenterol & Nutr, Nice, France.
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- Torreggiani, Massimo (författare)
- Ctr Hosp Le Mans, Nephrol & Dialyse, Ave Rubillard, F-72037 Le Mans, France.
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- Fouque, Denis (författare)
- Univ Lyon, Lyon SUD Hosp, Renal Dept, Hosp Civils Lyon, Pierre Benite, France.
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- Carrero, Juan Jesus (författare)
- Karolinska Institutet
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- Barazzoni, Rocco (författare)
- Univ Trieste, Dept Med Surg & Hlth Sci, Trieste, Italy.
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Ctr Hosp Le Mans, Nephrol & Dialyse, Ave Rubillard, F-72037 Le Mans, France Klinisk nutrition och metabolism (creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 42:4, s. 443-457
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Increased life expectancy is posing unprecedented challenges to healthcare systems worldwide. These include a sharp increase in the prevalence of chronic kidney disease (CKD) and of impaired nutritional status with malnutrition-protein-energy wasting (PEW) that portends worse clinical outcomes, including reduced survival. In older adults with CKD, a nutritional dilemma occurs when indications from geriatric nutritional guidelines to maintain the protein intake above 1.0 g/kg/day to prevent malnutrition need to be adapted to the indications from nephrology guidelines, to reduce protein intake in order to prevent or slow CKD progression and improve metabolic abnormalities. To address these issues, the European So-ciety for Clinical Nutrition and Metabolism (ESPEN) and the European Renal Nutrition group of the European Renal Association (ERN-ERA) have prepared this conjoint critical review paper, whose objec-tive is to summarize key concepts related to prevention and treatment of both CKD progression and impaired nutritional status using dietary approaches, and to provide guidance on how to define optimal protein and energy intake in older adults with differing severity of CKD. Overall, the authors support careful assessment to identify the most urgent clinical challenge and the consequent treatment priority. The presence of malnutrition-protein-energy wasting (PEW) suggests the need to avoid or postpone protein restriction, particularly in the presence of stable kidney function and considering the patient's preferences and quality of life. CKD progression and advanced CKD stage support prioritization of protein restriction in the presence of a good nutritional status. Individual risk-benefit assessment and appro-priate nutritional monitoring should guide the decision-making process. Higher awareness of the challenges of nutritional care in older adult patients with CKD is needed to improve care and outcomes. Research is advocated to support evidence-based recommendations, which we still lack for this increasingly large patient subgroup.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
Nyckelord
- CKD
- Older adults
- Malnutrition
- Skeletal muscle
- Low-protein diet
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- Av författaren/redakt...
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Piccoli, Giorgin ...
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Cederholm, Tommy
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Avesani, Carla M ...
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Bakker, Stephan ...
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Bellizzi, Vincen ...
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Cuerda, Cristina
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visa fler...
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Cupisti, Adamasc ...
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Sabatino, Alice
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Schneider, Steph ...
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Torreggiani, Mas ...
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Fouque, Denis
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Carrero, Juan Je ...
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Barazzoni, Rocco
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- MEDICIN OCH HÄLSOVETENSKAP
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Clinical Nutriti ...
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Uppsala universitet
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Karolinska Institutet