Nutritional Disorders in Chronic Kidney Disease

Nutritional status is one of the main modifiable factors that affect the prognosis and evolution of patients with acute and chronic kidney disease (CKD). Due to the kidney's unique role in nutrient metabolism, patients with kidney failure are unable to maintain adequate nutrient homeostasis. In the uremic milieu, a state of hypercatabolism, inflammation, and undernutrition leads to the development of Protein-energy Wasting (PEW) syndrome. Uremic syndrome is associated with loss of appetite and various gastrointestinal disorders that lead to a decrease in nutrient intake. Oral and gastrointestinal tract problems modify the quantity and quality of the food ingested. In patients for whom preventive approaches to PEW have been insufficient, the first therapeutic step should be intervention by a nutritionist, who will carry out a dietary assessment to evaluate whether the dietary intake is adequate in protein and caloric contents.