Journal of Clinical Nutrition & Dietetics

The protein energy wasting: the “Sword of Damocles” on the patients affected by chronic kidney failure

3^rd World Congress on Nutrition, Dietetics and Nutraceuticals
February 25-26, 2019 | Prague, Czech Republic

Piergiorgio Bolasco

Conservative Treatment of Chronic Kidney Disease Study Group of Italian Society of Nephrology, Italy

Keynote: J Clin Nutr Diet

DOI: 10.4172/2472-1921-C1-004

Abstract

The protein energy wasting (PEW) is a real and unavoidable threat in patients affected by advanced chronic kidney failure (CKD3-5) but above all patients undergoing dialysis (CKD5D). The report discusses the classification of PEW and about the triggering causes and its maintenance and/or worsening. Almost all the CKD3-5 show one or more signs of PEW due to inflammation and retention of toxic molecules that produces malnutrition and speeds up the progression of renal failure towards dialysis treatment. Furthermore, it exposes patients to all the worst comorbidities. In CKD5D patients the situation is even worse because the uremic inflammation is magnified by dialysis and especially hemodialysis. This report illustrates the most recent findings from literature and from many years of personal experience. Recently, after being forgotten for a decade, the importance of two determining factors for PEW is emerging: the loss of useful substances with dialysis such as amino acids even in the amount of about 1 kg per year, both essential and non-essential that branched chain types. This translates into a sure loss of fat mass but above all lean mass (muscles) with serious impairment of patients’ autonomy and quality of life if they is not lucky to receive a kidney transplantation in a short time. The other new strand is the now consolidated and proven impairment of intestinal microbiota by uremia. Therefore, international and personal experiences are reported to remedy and slow down the inexorable steps of PEW towards cachexia.

Biography

Piergiorgio Bolasco is a Nephrology Consultant since 40 years and was the Former Director of Territorial Department of Nephrology and Dialysis of Cagliari Area (Sardinia) for 20 years. His area of research interest includes dialectic methodologies, renal nutrition, chronic kidney diseases, renal lithiasis. He is a Member of Organizing Committee of World Nutrition OMICS Congress. He is the Author/Coauthor of 382 scientific publications and abstracts on nephrology and dialysis techniques including national and international journals and books. His 79 publications are currently present in Med-line. He is the Reviewer of Journals like Kidney International, Nephron, Nephrology Dialysis and Transplantation, Journal of Nephrology, American Journal of Kidney Disease, Artificial Organs, BMC Nephrology. He is the Member of Editorial Board of Giornale Italiano di Nefrologia, Journal of Nephrology, Minerva Urologica e Nefrologica and Editorial Manager of International Journal of Artificial Organs.

E-mail: pg.bolasco@gmail.com