More than 10% of the population worldwide is affected by kidney disease, with millions of patients dying each year because of poor healthcare facilities. Within the spectrum of kidney patients, elderly people and patients with chronic comorbid like diabetes and hypertension, are mostly affected.
Cases of kidney diseases are disproportionately increasing in developing countries, including India, where the number of senior citizens is also increasing. The treatment cost of dialysis and kidney transplantation creates a huge financial burden for the majority of elderly kidney patients.
There are also many other metabolic alterations that affect nutrition support in kidney diseases. These alterations also affect metabolism and energy expenditure, predispose patients to the development of malnutrition, and pose an increased risk of morbidity and mortality among kidney patients. Hence, chronic kidney diseases are gradually becoming a worldwide health crisis.
The main purpose of nutritional support in kidney diseases is to prevent or treat malnutrition, to reduce the accumulation of fluids, waste products, potassium, and phosphorus, and to prevent complications of the uremia (cardiovascular diseases, bone diseases, etc.)
Most patients who are in the early stages of kidney disorders are advised to limit the amount of sodium in their diet. Some patients would be required to limit their protein intake as well. Individuals with serious kidney problems might also have to cut down on their intake of phosphorus and potassium.
Leading dietitians and kidney specialists often recommend the DASH (Dietary Approaches to Stop Hypertension) diet and a plant-based diet for patients with kidney disorders. However, diet and nutritional support may differ from patient to patient.
Therefore, nephrologists make sure that during the nutritional treatment, patients are maintained on adequate energy and protein intake. They also see to it that there is a constant supply of Vitamins (including active vitamin D3). If required, doctors also suggest oral phosphate binders in extreme cases.
When it comes to the problem of malnutrition in certain renal cases, patients with chronic kidney diseases are at substantial risk for malnutrition, characterized by protein-energy wasting and micronutrient deficiency. Studies have proven a high prevalence rate of malnutrition in both children and adults affected by chronic kidney disorders. Malnutrition is extremely high, at about 40% of patients in the best centers worldwide.
Mere protein supplementation and nutrition support in kidney diseases may not adequately control malnutrition. There must be a multi-dimensional approach including the treatment of comorbidities. Therapeutic interventions that specifically target problems like inflammation and other metabolic derangements are the basis for the successful treatment of malnutrition in renal patients.
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