Assessing protein‑energy wasting in chronic kidney disease
DOI:
https://doi.org/10.18203/2320-6012.ijrms20234031Keywords:
Protein-energy wasting, Chronic kidney disease, Disease, NutrientsAbstract
Chronic kidney disease is often accompanied with a syndrome known as protein-energy wasting, which is defined by decreased protein consumption, protein loss due to metabolic disturbances, and physical consequences include sarcopenia and frailty. Due to population aging and advancements in the treatment of other chronic illnesses, this problem has drastically increased in recent years. The frequency of morbidity and death in chronic kidney disease patients may be greatly decreased with proper therapy of as protein-energy wasting. Therefore, it's crucial to prevent and manage as protein-energy wasting in chronic kidney disease patients by doing a thorough evaluation and offering each patient a customized, evidence-based treatment plan. Once protein-energy wasting is recognized, a nutritionist should be contacted to create a management strategy. A thorough diet specifically designed to fit the patient's requirements, any required nutritional supplements, and counselling about dietary changes, symptom management, and psychological support should all be part of this strategy. The risk of protein-energy wasting may be decreased with proper assessment and care. This includes changes to one's diet, resistance training or other forms of exercise, dialysis or organ transplantation when necessary, and drugs to treat any underlying disorders.
References
Krizanova A, Lăzăroiu G, Gajanova L, Kliestikova J, Nadanyiova M, Moravcikova D. The Effectiveness of Marketing Communication and Importance of Its Evaluation in an Online Environment. Sustainability. 2019;11(24):7016.
Kopple JD. National Kidney Foundation K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2001;37.
Sen D, Prakash J. Nutrition in Dialysis Patients. J Assoc Physicians India. 2000;48(7).
Kato A, Takita T, Furuhashi M, Maruyama Y, Hishida A. Comparison of serum albumin, C-reactive protein and carotid atherosclerosis as predictors of 10-year mortality in hemodialysis patients. Hemodial Int. 2010;14(2).
Kalantar-Zadeh K, Cano NJ, Budde K, Chazot C, Kovesdy CP, Mak RH, et al. Diets and enteral supplements for improving outcomes in chronic kidney disease. Nat Rev Nephrol. 2011;7(7):369-84.
Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-Inflammation Complex Syndrome in Dialysis Patients: Causes and Consequences. Am J Kidney Dis. 2003;42(5).
Kalantar-Zadeh K. Recent advances in understanding the malnutrition-inflammation-cachexia syndrome in chronic kidney disease patients: What is next? Semin Dial. 2005;18(5).
Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73.
Lodebo BT, Shah A, Kopple JD. Is it Important to Prevent and Treat Protein-Energy Wasting in Chronic Kidney Disease and Chronic Dialysis Patients? J Ren Nutr. 2018;28(6).
St-Jules DE, Fouque D. A Novel Approach for Managing Protein-Energy Wasting in People With Kidney Failure Undergoing Maintenance Hemodialysis: Rationale and Call for Trials. Am J Kidney Dis. 2022;80(2).
Tennankore KK, Bargman JM. Nutrition and the Kidney: Recommendations for Peritoneal Dialysis. Adv Chronic Kidney Dis. 2013;20(2).
Jadeja Y, Kher V. Protein energy wasting in chronic kidney disease: An update with focus on nutritional interventions to improve outcomes. Indian J Endocrinol Metab. 2012;16(2).
Dukkipati R, Kopple JD. Causes and Prevention of Protein-Energy Wasting in Chronic Kidney Failure. Semin Nephrol. 2009;29(1).
Post A, Groothof D, Schutten JC, Kelly D, Swarte JC, Flores-Guerrero JL, et al. Fibroblast growth factor 21 and protein energy wasting in hemodialysis patients. Clin Nutr. 2021;40(6).
Yamada S, Tsuruya K, Kitazono T, Nakano T. Emerging cross-talks between chronic kidney disease–mineral and bone disorder (CKD–MBD) and malnutrition–inflammation complex syndrome (MICS) in patients receiving dialysis. Clin Exp Nephrol. 2022;26(7).
Hanna RM, Ghobry L, Wassef O, Rhee CM, Kalantar-Zadeh K. A Practical Approach to Nutrition, Protein-Energy Wasting, Sarcopenia, and Cachexia in Patients with Chronic Kidney Disease. Blood Purif. 2020;49(1-2).
Osunbor OA, Unuigbe EI, Okaka EI, Adejumo OA. Protein energy wasting in pre-dialysis chronic kidney disease patients in Benin City, Nigeria: A cross-sectional study. PLoS One. 2023;18(5 May). doi:10.1371/journal.pone.0286075
Kanda E. Nutritional Management in Elderly CKD Patients in Japan. J Nutr Sci Vitaminol (Tokyo). 2022;68.
Caldiroli L, Armelloni S, Eskander A, Messa P, Rizzo V, Margiotta E, et al. Association between the uremic toxins indoxyl-sulfate and p-cresyl-sulfate with sarcopenia and malnutrition in elderly patients with advanced chronic kidney disease. Exp Gerontol. 2021;147.
Graterol Torres F, Molina M, Soler-Majoral J, Romero-González G, Rodríguez Chitiva N, Troya-Saborido M, et al. Evolving Concepts on Inflammatory Biomarkers and Malnutrition in Chronic Kidney Disease. Nutrients. 2022;14(20).
Karava V, Dotis J, Kondou A, Printza N. Malnutrition Patterns in Children with Chronic Kidney Disease. Life. 2023;13(3).
Pérez-Torres A, González Garcia ME, San José-Valiente B, Bajo Rubio MA, Celadilla Diez O, López-Sobaler AM, et al. Protein-energy wasting syndrome in advanced chronic kidney disease: Prevalence and specific clinical characteristics. Nefrologia. 2018;38(2).
Iyengar A, Raj JM, Vasudevan A. Protein Energy Wasting in Children With Chronic Kidney Disease and End-Stage Kidney Disease: An Observational Study. J Ren Nutr. 2021;31(3).
Magnard J, Deschamps T, Cornu C, Paris A, Hristea D. Effects of a six-month intradialytic physical ACTIvity program and adequate NUTritional support on protein-energy wasting, physical functioning and quality of life in chronic hemodialysis patients: ACTINUT study protocol for a randomised controlled trial. BMC Nephrol. 2013;14(1).
Hristea D, Deschamps T, Paris A, Lefrançois G, Collet V, Savoiu C, et al. Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy. Nephrology. 2016;21(9).
Mahmoud M, Nagy E, AbdAlBary M, El-Kannishy G, Sayed-Ahmed N. Relation of protein energy wasting to carotid intima media thickness in hemodialysis patients. J Hum Hypertens. 2021;35(7).
Nitta K, Tsuchiya K. Recent advances in the pathophysiology and management of protein-energy wasting in chronic kidney disease. Ren Replace Ther. 2016;2(1).
Pérez-Torres A, González Garcia E, Garcia-Llana H, del Peso G, López-Sobaler AM, Selgas R. Improvement in Nutritional Status in Patients With Chronic Kidney Disease-4 by a Nutrition Education Program With No Impact on Renal Function and Determined by Male Sex. J Ren Nutr. 2017;27(5).
Piccoli GB, Cederholm T, Avesani CM, Bakker SJL, Bellizzi V, Cuerda C, et al. 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. Clin Nutr. 2023;42(4):443-57.
Gracia-Iguacel C, González-Parra E, Barril-Cuadrado G, Sánchez R, Egido J, Ortiz-Arduán A, et al. Defining protein-energy wasting syndrome in chronic kidney disease: Prevalence and clinical implications. Nefrologia. 2014;34(4):507-19.
Romejko K, Rymarz A, Sadownik H, Niemczyk S. Testosterone Deficiency as One of the Major Endocrine Disorders in Chronic Kidney Disease. Nutrients. 2022;14(16).
Leśniak K, Rymarz A, Sobol M, Dymus J, Woźniak-Kosek A, Niemczyk S. Testosterone Deficiency and Nutritional Parameters as Predictors of All-Cause Mortality among Male Dialysis Patients. Nutrients. 2022;14(21).
Miyamoto T, Carrero JJ, Qureshi AR, Anderstam B, Heimbürger O, Bárány P, et al. Circulating follistatin in patients with chronic kidney disease: Implications for muscle strength, bone mineral density, inflammation, and survival. Clin J Am Soc Nephrol. 2011;6(5):1001-8.