Rehabilitation nutrition support for a hemodialysis patient with protein-energy wasting and sarcopenic dysphagia: a case report

Abstract

Background: Patients with end-stage renal failure may exhibit sarcopenia and protein-energy wasting (PEW). We report a case of improvement in physical function, muscle mass, and muscle strength by management of rehabilitation nutrition in a maintenance hemodialysis patient with PEW and sarcopenia. Case presentation: A 60-year-old man with an 8-year history of dialysis was admitted for pneumococcal meningitis. When he was transferred for rehabilitation 36 days following the onset, he was transferred to our hospital for rehabilitation and hemodialysis. On admission, energy intake was 1200 kcal/day, via a nasogastric tube, due to sarcopenic dysphagia. He was diagnosed with PEW, based on results from a biochemical examination, physical examination, and his low dietary intake. His height, dry weight, body mass index, Mini Nutritional Assessment-Short Form, albumin, C-reactive protein, and Geriatric Nutritional Risk Index were 166 cm, 46.5 kg, 16. 9 kg/m

Prevalence of nutritional risk and its impact on functional recovery in older inpatients on maintenance hemodialysis: a retrospective single-center cohort study

“…There is also evidence in patients with stroke and hip fracture that nutritional improvement is associated with greater gains in ADLs [25][26][27]. The concept of rehabilitation nutrition involving rehabilitation and management of nutritional care is important in MHD patients with impaired ADLs [28].…”

Effects of Physical Rehabilitation and Nutritional Intake Management on Improvement in Tongue Strength in Sarcopenic Patients

“…Wakabayashi et al [ 29 ] have also reported that resistance training of the swallowing muscles tends to improve dysphagia in subjects with sarcopenic dysphagia compared with that in subjects with dysphagia that is caused by other factors such as stroke. Moreover, several case reports have indicated that intervention for whole-body sarcopenia can be effective for sarcopenic dysphagia, in addition to dysphagia training [ 30 , 31 , 32 , 33 ]. In these case reports, strict nutritional support was provided along with systemic rehabilitation [ 30 , 31 , 32 ].…”