[Nutritional aspects in renal failure]

Abstract

Patients with kidney failure are a high nutritional risk group. Patients with acute kidney failure need and energy intake of 30-40 kcal/kg and a protein intake of 0,8-1 g/kg of ideal weight, that it is increased with glomerular filtration improvement. Potassium must be limited to 30-50 mEq/day and sodium to 20-40 mEq/day in oliguric phase, and must be replaced the losses in diuretic phase. Specific recommendations have been designed to some nutrients. A diet with 0.75-1 g/kg/day of proteins must be recommended in patients with chronic kidney failure (CDF). Low protein diets (<0.6 g/kg/day) are not justified, due to a possible malnutrition might be developed (A). In patients with haemodialysis, energy requirements are 35 Kcal/kg/day. Protein recommendations are 1.2-1.4 g/Kg/day. Water recommendations depend of residual diuresis. 500-800 ml must be added to residual diuresis. Sodium must limited to 60-100 meq/day, with a depth reduction of water and sodium in anuric patients. Potassium must be under 1 meq/kg/day. Patients with peritoneal dialysis had different dietary recommendations. Protein recommendations are higher than previous (1.5 g/Kg/day). Energy recommendations from carbohydrates must be included glucose of dialyser liquid (60% of total amount). Diet has low restrictions due to the daily sessions of peritoneal dialysis, for example potassium intakes can reach 2000-3000 mg/day. Hidrosoluble vitamin losses are lower than patients with haemodialysis.