Abstract
Guidelines for the use of oral nutritional supplements (ONS) and enteral nutrition (tube feeding, EN) in kidney disease patients have been published recently. In conservatively treated patients with chronic kidney disease and/or nephrotic syndrome, ONS and EN have been poorly investigated. They are indicated during protein-energy wasting (PEW) and acute associated illnesses. In maintenance hemodialysis (MHD) and chronic peritoneal dialysis patients, the adverse impact of PEW on survival is a major concern. In MHD patients, ONS have been shown to improve nutritional status. Moreover, morbidity and mortality can be reduced when nutritional status, as assessed by serum transthyretin (prealbumin), is improved with nutritional support. Intensive care patients with acute kidney injury are characterized by a very high catabolic rate and major protein losses. PEW in such patients is responsible for high mortality rates. EN via tube feeding, given alone or in association with parenteral nutrition, is a component in the management of these patients.
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