How to prevent protein-energy wasting in patients with chronic kidney disease--position statement of the Croatian Society of Nephrology, Dialysis and Transplantation
Kako prevenirati i liječiti proteinsko-energetsku pothranjenost u bolesnika s kroničnom bolešću bubrega--osvrt hrvatskog društva za nefrologiju, dijalizu i transplantaciju na preporuke medunarodnog društva za prehranu bubrežnih bolesnika

Nikolina Bašić-Jukić, Sanjin Rački, Petar Kes, Dragan Ljutić, Bozidar Vujičić, Vesna Lovčić, Lidija Orlić, Ingrid Prkačin, Josipa Radić, Marko Jakić, Dragan Klarić, Marijana Gulin (+1 others)
2014 Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti  
Protein-energy wasting (PEW) is a frequent problem in patients with end-stage renal disease, which is associated with adverse outcome. Risk factors for development of PEW in dialysis patients include anorexia, limitations in food intake due to problems with mineral metabolism (hyperphosphatemia, hyperkalemia). Prevention of PEW in dialysis population demands different therapeutic measures to correct abnormalities and to prevent loss of energy and proteins. Therapeutic approach should be
more » ... alized based on the specific problems of each patient in order to correct metabolic problems and to optimize food intake. In patients with inability to maintain nutritional status with standard oral feeding, other measures which include oral nutrition supplements and intradialytic parenteral feeding should be applied. Anabolic steroids, growth hormone and adequate oral nutritional supplements, together with physical activity may prevent further catabolism and correct abnormalities. Appetite stimulators, antiinflammatory interventions and anabolic drugs seem promising; however, their efficacy should be investigated in future clinical trials.
pmid:26012159 fatcat:64r5eaocu5gvjmujroq2g6odyi