Expert Working Group report on nutrition in adult patients with renal insufficiency (part 1 of 2)

The second part of the report deals with the nutritional therapy of 1) patients with chronic renal failure on haemodialytic treatment or peritoneal dialysis, 2) patients with nephrotic syndrome, 3) patients with acute renal failure and 4) kidney transplanted patients. Each of these situations is unique as to the aetiology of malnutrition and nutritional treatment. Haemodialytic treatment or peritoneal dialysis are in themselves additional catabolic stimuli. Preventing protein-energy malnutrition in hemodialysis patients is important because of its prognostic relevance. Peritoneal dialysis patients pose a special problem because the energy intake can be in excess, while the nitrogen balance is often negative, and they are at risk of developing a kwashiorkor-like syndrome. The nutritional risk of patients with acute renal failure and the diAculty in nourishing them adequately is outlined. Specific recommendations are given for the pre-transplant, early posttransplant and late post-transplant phases.