Nutrition in Renal Supportive Care: Patient‐driven and flexible

Abstract

Renal Supportive Care is an alternative treatment pathway in advanced chronic kidney disease that is being increasingly adopted, particularly in the elderly. Renal Supportive Care uses principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non‐dialysis pathway. Nutrition management is often an under‐recognized component of care and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of Renal Supportive Care are met. Nutrition interventions need to target patient and treatment goals, with frequent monitoring to ensure patient needs are being met. This review outlines available literature on this topic and suggests some practical ways in which nutrition can be enhanced for these patients.

Recomendaciones nutricionales en cuidados paliativos para pacientes con enfermedades avanzadas y al final de la vida

“…Se ha demostrado ampliamente que las terapias nutricionales guiadas y controladas por equipos especializados y multidisciplinares alcanzan mejores resultados (9)(10)(11)(12) . En general, y teniendo en cuenta que la fisiopatología y los tratamientos están fuera del alcance de este trabajo, las complicaciones del soporte nutricional se pueden clasificar en:…”

“…La ERC es un importante problema de salud pública, que está creciendo en todo el mundo (12) . Estos pacientes suelen tener múltiples comorbilidades asociadas, que deben ser abordadas en profundidad.…”

Supporting and maintaining the frail patient on long-term renal replacement therapy

“…The dietary strategy utilised should support the patient to make informed diet-related decisions, reduce food-related anxiety and incorporate cultural values and social aspects of eating with counselling from a registered dietitian with experience in this area. 17 The syndrome of frailty and chronic kidney disease is associated with poor dietary intake and sarcopenia. Exercise programmes designed to maintain and promote independence in frail patients should be supported by a higher energy, proteincontrolled diet under the supervision of a dietitian.…”

“…Exercise programmes designed to maintain and promote independence in frail patients should be supported by a higher energy, proteincontrolled diet under the supervision of a dietitian. 17 The end of life is often associated with a reduced appetite and desire to drink. Patients and their families should be reassured to reduce anxiety regarding nutritional intake and following dietary restrictions and the patient encouraged to focus on foods most enjoyed.…”

“…Patients and their families should be reassured to reduce anxiety regarding nutritional intake and following dietary restrictions and the patient encouraged to focus on foods most enjoyed. 17…”