Alarcón ORJ

Language: Spanish
References: 10
Page:
PDF size: 53.40 Kb.

ABSTRACT

Rationale. Energy Nutrient Malnutrition (ENM) is a frequent complication of End-Stage Renal Disease (ESRD). The prevalence of ENM in this population of patients is estimated between 18–56%. While 33% of the ESRD patients can be mildly or moderately malnourished, 6% can be severely affected. Thus, ENM can become a significant cause of morbidity and mortality among these patients. ENM is associated with an increase in the hospitalization rates, a greater number of admissions per patient per year, longer lengths of stay, and a consequently increase in hospitalization costs. There is also an increase in complications resulting from the dialytic treatment itself,making these therapies more difficult to perform. Objective. To assess the benefits of the available nutritional support therapies for ERSD-patients, with emphasis on Intradialytic Parenteral Nutrition (NPID), to establish the fundamentals for treating and preventing ENM in ESRD-patients, and to assess the costs of each particular treatment. Material and Methods. The most important aspects of malnutrition in ESRD-patients were reviewed, as well as the nutritional recommendations suggested by leading investigators in the field over the last 5 years, and the main forms of nutritional support therapies. Conclusions. NPID is a treatment with well-defined indications, high costs, and positive outcomes in the nutritional therapy of the ESRD patients on dialysis.

REFERENCES

1. Workshop on nutritional support in dialysis with a focus on the role of intradialitic parenteral nutrition. Am J Kidney Dis 1999;33(1):170-1.

2. Klahr S. Enfermedad renal. En: Organización Panamericana de la Salud, Instituto Internacional de Ciencias de la Vida. Conocimientos actuales sobre nutrición. 6a edición. Washington, DC: OPS/ILSI; 1991; 436-44 (Publicación científica 532).

3. Nelson JK, Moxness KE, Jensen MD, Gatineau CF. Dietética y nutrición: manual de la Clínica Mayo. 7a edición Madrid: Harcourt Brace; 1996.p.313-23.

4. Mitch WE, Maroni BJ. Factors causing malnutrition in patients with chronic uremia. Am J Kidney Dis 1999;33:313-23.

5. Kopple JD. Therapeutic approaches to malnutrition in chronic dialysis patients: the different modalities of nutritional support. Am J Kidney Dis 1999;33:180-5.

6. Foulk Ch J. An evidence. Based evaluation of intradialytic parenteral nutrition. Am J Kidney Dis 1999; 33(1):186-92.

7. Brewer E. Experience with intradilytic parenteral nutrition and supplementad tube feeding. Am J Kidney Dis 1999;33(1):205-7.

8. Chertow G M. Modality-specific nutrition support in ESRD: weighing the evidence .Am J Kidney Dis 1999;33(1):193-7.

9. Lazarus JM. Recomended criteria for initiating and discontinuing intradialitic parenteral nutrition therapy. Am J Kidney Dis 1999; 33(1):211-15.

10. Blondin J. Nutritional status: A continuous quality improvementapproach. Am J Kidney Dis 1999;33(1):198-202.