Introduction High prevalence of malnutrition exists in patients with CKD. Several surveys have reported protein-calorie malnutrition in up to 40% of CKD pts. Risk for malnutrition increases as CKD progresses. Malnutrition in CKD is multifactors. Surveys consistently report inadequate oral intake >>>major contributing factor. Ann Rev Nutr, 2001;21:
Nutritional Challenges in CKD Undernourished patients with ESRD Significantly increased morbidity : 27% - 43% increased risk for stroke Independently associated with increased mortality. -Results in more & longer hospitalizations & higher health care costs. Negatively affects functioning & quality of life
Serum albumin concentration and survival in patients with nondialysis-dependent CKD Am. J. Clin. Nutr. 90, 407–414 (2009).
Protein-Energy Malnutrition (PEM) a lack of adequate energy or protein supply that meets the metabolic demands placed on the body by one or more of the following: inadequate protein intake from dietary sources ingestion of poor quality protein increased demands resulting from disease increased loss of nutrients
CKD..influence on nutritional status?
Uremic malnutrition Poor nutritional status in CKD..caused by 1.insufficient dietary intake 2.metabolic disturbances Semin Nephrol 2006;26: