Methods of nutrition therapy of patients with chronic kidney disease

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The article is devoted to the choice of nutritional therapy (NT) and nutritional supplementation in pre-dialysis stages of chronic kidney disease (CKD) and in patients on renal replacement therapy (RRT). Modern data on the prevalence and pathogenesis of protein-energy wasting (PEW) in uremia are presented, early detection of PEW and proper prescription of NT are justified. The options for enteral nutrition with oral nutrition supplementation/supplements (ONS) and their effectiveness in the general population of patients with CKD and PEW, and in different phenotypic groups of PEW are discussed. Specific requirements for modern specific renal ONS are presented. Various combinations of ONS with physical exercises and with using of some other nutritional components are described.

Full Text

Restricted Access

About the authors

Nataliia A. Mikhailova

Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: natmikhailova@mail.ru
ORCID iD: 0000-0001-5819-4360

PhD, Associate Professor of Nephrology Department of Russian Medical Academy of Continuous Professional Education

Russian Federation, Moscow

References

  1. Coresh J., Selvin E., Stevens L.A., et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038–47. doi: 10.1001/jama.298.17.2038.
  2. Hill N.R., Fatoba S.T., Oke J.L., et al. Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PLoS ONE. 2016;11(7):e0158765.
  3. Foreman K.J., Marquez N., Dolgert A., et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet. 2018;392(10159):2052–90. doi: 10.1016/S0140-6736(18)31694-5.
  4. Фадин Д.В., Федин В.А., Зингерман Б.В. и др. Результаты 5-летнего опыта тестирования лабораторией ИНВИТРО скорости клубочковой фильтрации на территории РФ. Клиническая нефрология. 2021;2:20–26. Doi.10.18565/nephrology.2021.2.27-33. [Fadin D.V., Fedin V.A., Zingerman B.V., et al. The results of 5-year experience in testing the glomerular filtration rate by the INVITRO laboratory in the territory of the Russian Federation. Clinical Nephrology. 2021;2:20–26. Doi.10.18565/nephrology.2021.2.27-33].
  5. Томилина Н.А., Волгина Г.В., Бикбов Б.Т. Хроническая болезнь почек. Избранные главы нефрологии. М., 2017. С. 245–47. [Tomilina N.A., Volgina G.V., Bikbov B.T. Chronic kidney disease. Selected chapters of Nephrology. M., 2017. Р. 245–47. (In Russ.)].
  6. Pupim L.B., Ikizler T.A. Uremic malnutrition: new insights into an old problem: review. Semin. Dial. 2003;16(3):224–32. doi: 10.1046/j.1525-139x.2003.16046.x.
  7. Evans W.J., Morley J.E., Argilés J., et al. Cachexia: a new definition. Clin. Nutr. Edinb. Scotl. 2008;27:793–99. doi: 10.1016/j.clnu.2008.06.013.
  8. Fouque D., Kalantar-Zadeh K., Kopple J., et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391–98 doi: 10.1038/sj.ki.5002585.
  9. Ветчинникова О.Н., Пичугина И.С. Белково-энергетическая недостаточность у больных на перитонеальном диализе: факторы риска развития и диагностика. Клиническая нефрология. 2015;1:55–63. [Vetchinnikova O.N., Pichugina I.S. Protein-energy malnutrition in peritoneal dialysis patients: risk factors and diagnosis. Clinical Nephrology. 2015;1:55–63].
  10. Dong J., Wang T., Wang H.Y. The impact of new co-morbidities on nutritional status in continuous ambulatory peritoneal dialysis patients. Blood Purif. 2006;24(5–6):517–23. doi: 10.1159/000096472.
  11. Scialla J.J., Appel L.J., Astor B.C., et al. Estimated net endogenous acid production and serum bicarbonate in African Americans with chronic kidney disease. Clin. J. Am. Soc. Nephrol. 2011;6:1526–32. doi: 10.2215/CJN.00150111.
  12. Morley J.E. Anorexia of aging: physiologic and pathologic. Am. J. Clin. Nutrit. 1997;66:760–73. doi: 10.1093/ajcn/66.4.760.
  13. Schürch M.A., Rizzoli R., Slosman D., et al. Protein supplements increase serum insulinlike growth factor-i levels and attenuate proximal femur bone loss in patients with recent hip fracture. a randomized, double-blind, placebo-controlled trial. Ann. Intern. Med. 1998;128:801–9. doi: 10.7326/0003-4819-128-10-199805150-00002.
  14. Levine M.E., Suarez J.A., Brandhorst S., et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell. Metab. 2014;19(3):407–17. doi: 10.1016/j.cmet.2014.02.006.
  15. Cheema B., Abas H., Smith B., et al. Investigation of skeletal muscle quantity and quality in end-stage renal disease. Nephrol. 2010;15(4):454–63. doi: 10.1111/j.1440-1797.2009. 01261.x.
  16. Яковенко А.А., Румянцев А.Ш. Распространенность белково-энергетической недостаточности у пациентов, получающих лечение программным гемодиализом. Нефрология и диализ. 2019;21(1):66–71. Doi: 10.28996. [Yakovenko A.A., Rumyantsev A.S. Prevalence of protein-energy deficiency in patients receiving treatment with programmed hemodialysis. Nephrology and dialysis. 2019;21(1):66–71. Doi: 10.28996. (In Russ.)].
  17. Shu Х., Lin Т., Wang Н., et al. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis. J. Cachex. Sarcopen. Muscle. 2022;13:145–58. doi: 10.1002/jcsm.12890.
  18. Ikizler T.A., Burrowes J.D., Byham-Gray L.D., et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am. J. Kidney Dis. 2020;76:S1–107. doi: 10.1053/j.ajkd.2020.05.006.
  19. Ku E., Kopple J.D., Johansen K.L., et al. Longitudinal weight change during CKD progression and its association with subsequent mortality. Am. J. Kidney Dis. 2017;71(5):657–6. doi: 10.1053/j.ajkd.2017.09.015.
  20. Robinson B.M., Zhang J., Morgenstern H., et al. Worldwide, mortality risk is high soon after initiation of hemodialysis. Kidney Int. 2014;85(1):158–65. doi: 10.1038/ki.2013.252.
  21. Thijssen S., Wong M.M., Usvyat L.A., et al. Nutritional competence and resilience among hemodialysis patients in the setting of dialysis initiation and hospitalization. Clin. J. Am. Soc. Nephrol. 2015;10(9):1593–603. doi: 10.2215/CJN.08430814.
  22. Blumberg B.S., Barnea Z., Cernes R., et al. Association of nutrition status at dialysis start with long-term survival: a 10-year retrospective study. J. Renal Nutrit. 2022;32(6):758–65. doi: 10.1053/j.jrn.2022.01.001.
  23. Qin A., Tan J., Hu W., et al. Oral energy supplementation improves nutritional status in hemodialysis patients with protein–energy wasting: A pilot study. Front. Pharmacol. 2022;13:839803. doi: 10.3389/fphar.2022.839803.
  24. Guo Y., Zhang M., Ye T., et al. Non-protein energy supplement for malnutrition treatment in patients with chronic kidney disease. Asia Pac. J. Clin. Nutr. 2022;31(3):504–11. doi: 10.6133/apjcn.202209_31(3).0017.
  25. Wu H.L., Sung J.M., Kao M.D., et al. Nonprotein calorie supplement improves adherence to low-protein diet and exerts beneficial responses on renal function in chronic kidney disease. J. Ren. Nutr. 2013;23:271–76. doi: 10.1053/j.jrn.2012.09.003.
  26. Małgorzewicz S., Rutkowski P., Jankowska V.M., et al. Effects of renal-specific oral supplementation in malnourished hemodialysis patients. J. Ren. Nutrit. 2011;21(4):347–53. doi: 10.1053/j.jrn.2010.07.001.
  27. Wong M.M.Y., Zheng Y., Renouf D., et al. Trajectories of Nutritional Parameters Before and After Prescribed Oral Nutritional Supplements: A Longitudinal Cohort Study of Patients With Chronic Kidney Disease Not Requiring Dialysis. Canad. J. Kidney Health Dis. 2022;9:1–9. doi: 10.1177/20543581211069008.
  28. Turkmen K., Guney I., Yerlikaya F.H., Tonbul H.Z. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren. Fail. 2012;34(2):155–9. doi: 10.3109/0886022X.2011.641514.
  29. Fotiadou E., Georgianos P.I., Chourdakis M., et al. Eating during the Hemodialysis Session: A practice improving nutritional status or a risk factor for intradialytic hypotension and reduced dialysis adequacy? Nutrients. 2020;12:1703. doi: 10.3390/nu12061703.
  30. Mah J.Y., Choy S.W., Roberts M.A., et al. Oral protein-based supplements versus placebo or no treatment for people with chronic kidney disease requiring dialysis. Cochrane Database Syst. Rev. 2020;5:CD012616. doi: 10.1002/14651858.
  31. Noor H., Reid J., Slee A. Resistance exercise and nutritional interventions for augmenting sarcopenia outcomes in chronic kidney disease: a narrative review. J. Cachex. Sarcopen. Muscl. 2021;12:1621–40. doi: 10.1002/jcsm.12791.
  32. Cheu C., Pearson J., Dahlerus C., et al. Association between oral nutritional supplementation and clinical outcomes among patients with ESRD. Clin. J. Am. Soc. Nephrol. 2013;8(1):100–7. doi: 10.2215/CJN.13091211.
  33. Lacson E., Wang W., Zebrowski B., et al. Outcomes associated with intradialytic oral nutritional supplements in patients undergoing maintenance hemodialysis: a quality improvement report. Am. J. Kidney Dis. 2012;60(4):591–600. doi: 10.1053/j.ajkd.2012.04.019.
  34. Suryantoro S.D., Ardhany R.A., Basoeki W., et al. Dietary management of haemodialysis patients with chronic kidney disease and malnourishment. Asia Pac. J. Clin. Nutr. 2021;30(4):579–87. doi: 10.6133/apjcn.202112_30(4).0004.
  35. Cano N.J., Fouque D., Roth H., et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J. Am. Soc. Nephrol. 2007;18(9):2583–91. doi: 10.1681/ASN.2007020184.
  36. Cano N. Nutritional supplementation in adult patients on hemodialysis. J. Ren. Nutr. 2007;17(1):103–5. doi: 10.1053/j.jrn.2006.10.018.
  37. Sarav V., Friedman A.N. Use of intradialytic parenteral nutrition in patients undergoing hemodialysis. Nutr. Clin. Pract. 2018;33(6):767–71. doi: 10.1002/ncp.10190.
  38. Rhodes C. Enteral Nutrition in Adults with Chronic Kidney Disease: Things to Consider. J. Ren. Nutrit. 2021;31(4):427–30. doi: 10.1053/j.jrn.2021.02.008.
  39. Kittiskulnam P., Banjongjit A., Metta К., et al. The benefcial efects of intradialytic parenteral nutrition in hemodialysis patients with protein energy wasting: a prospective randomized controlled trial. Sci. Rep. 2022;2:4529. doi: 10.1038/s41598-022-08726-8.
  40. Li F.K., Chan L.Y.Y., Woo J.C.Y., et al. A 3-year, prospective, randomized, controlled study on amino acid dialysate in patients on CAPD. Am. J. Kidney Dis. 2003;42(1):173–83. doi: 10.1016/s0272-6386(03)00421-9.
  41. Tjiong H.L., van den Berg J.W., Wattimena J.L., et al. Dialysate as Food: combined Amino Acid and Glucose Dialysate Improves Protein Anabolism in Renal Failure Patients on Automated Peritoneal Dialysis. J. Am. Soc. Nephrol. 2005;16(5):1486. doi: 10.1681/ASN.2004050402.
  42. Tjiong H.L., Rietveld T., Wattimena J.L., et al. Peritoneal Dialysis with Solutions Containing Amino Acids Plus Glucose Promotes Protein Synthesis during Oral Feeding. Clin. J. Am. Soc. Nephrol. 2007;2(1):74. doi: 10.2215/CJN.01370406.
  43. Dombros N., Dratwa M., Feriani M., et al. European best practice guidelines for peritoneal dialysis. 5 Peritoneal dialysis solutions. Nephrol. Dial. Transplantat. 2005;20(Suppl. 9):ix16–20. doi: 10.1093/ndt/gfi1119.
  44. Lochmann H. The benefits of fiber in chronic kidney. J. Ren. Nutrit. 2022;32(6):e1–4. doi: 10.1053/j.jrn.2022.07.001.
  45. Ikee R., Yano K., Tsuru T. Constipation in chronic kidney disease: it is time to reconsider. Ren. Replacem. Ther. 2019;5:51. doi: 10.1186/s41100-019-0246-3.
  46. Yong K., Mori T., Chew G., et al. The effects of OMEGA-3 fatty acid supplementation upon interleukin-12 and interleukin-18 in chronic kidney disease patients. J. Ren. Nutrit. 2019;29(5):377–85. doi: 10.1053/j.jrn.2019.01.001.
  47. Marini A.C.B., Motobu R.D., Freitas A.T.V., et al. Short-term creatine supplementation may alleviate the malnutrition-inflammation score and lean body mass loss in hemodialysis patients: a pilot randomized placebo-controlled trial. J. Parenteral Enteral Nutrit. 2019;00:1–8. doi: 10.1002/jpen.1707.
  48. Rossi M., Johnson D.V., Campbell K.L. The Kidney–Gut Axis: Implications for Nutrition Care. J. Ren. Nutrit. 2015;25(5):399–403. doi: 10.1053/j.jrn.2015.01.017.
  49. Есаян А.М., Арутюнов Г.П., Мелихов О.Г. Распространенность хронической болезни почек среди пациентов, обратившихся в учреждения первичной медико-санитарной помощи. Результаты проспективного наблюдательного исследования в 12 регионах России. Клиническая нефрология. 2021;3:6–16. [Essaian A.M., Arutyunov G.P., Melikhov O.G. Prevalence of chronic kidney disease in primary care patients. results of a prospective observational study in 12 regions of Russia. Clinical Nephrology. 2021;3:6–16 (In Russ.)].
  50. Ягудина Р.И., Серпик В.Г., Абдрашитова Г.Т., Котенко О.Н., Экономическое бремя хронической болезни почек в российской федерации. Фармакоэкономика. Теория и практика. 2014;2(4):34–39. [Yagudina R.I., Serpik V.G., Abdrashitova G.T., Kotenko O.N., The economic burden of chronic kidney disease in the Russian Federation. Pharmacoeconomics. Theory and practice. 2014;2(4):34–39. (In Russ.)].
  51. Свидетельство о регистрации RU 77.99.32.004.E.000369.01.17. [Certificate of registration RU 77.99.32.004.E.000369.01.17 (In Russ.)].

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies