Fiaccadori E, Sabatino A, Barazzoni R, Carrero JJ, Cupisti A, De Waele E, Jonckheer J, Singer P, Cuerda C, et al.
Clinical nutrition (Edinburgh, Scotland). Date of publication 2021 Apr 1;volume 40(4):1644-1668.
1. Clin Nutr. 2021 Apr;40(4):1644-1668. doi: 10.1016/j.clnu.2021.01.028. Epub 2021
Feb 9.
ESPEN guideline on clinical nutrition in hospitalized patients with acute or
chronic kidney disease.
Fiaccadori E(1), Sabatino A(2), Barazzoni R(3), Carrero JJ(4), Cupisti A(5), De
Waele E(6), Jonckheer J(7), Singer P(8), Cuerda C(9).
Author information:
(1)Nephrology Unit, Parma University Hospital, & Department of Medicine and
Surgery, University of Parma, Parma, Italy. Electronic address:
enrico.fiaccadori@unipr.it.
(2)Nephrology Unit, Parma University Hospital, & Department of Medicine and
Surgery, University of Parma, Parma, Italy.
(3)Internal Medicine, Department of Medical, Surgical and Health Sciences,
University of Trieste, Trieste, Italy.
(4)Department of Medical Epidemiology and Biostatistics, Karolinska Institutet,
Stockholm, Sweden.
(5)Nephrology Unit, Department of Clinical and Experimental Medicine, University
of Pisa, Pisa, Italy.
(6)Intensive Care, University Hospital Brussels (UZB), Department of Nutrition,
UZ Brussel, Faculty of Medicine and Pharmacy, Vrije Unversiteit Brussel (VUB),
Bruxelles, Belgium.
(7)Intensive Care, UZ Brussel, Bruxelles, Belgium.
(8)General Intensive Care Department and Institute for Nutrition Research, Rabin
Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel.
(9)Nutrition Unit, Hospital General Universitario Gregorio Marañon, Instituto de
Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Acute kidney disease (AKD) - which includes acute kidney injury (AKI) - and
chronic kidney disease (CKD) are highly prevalent among hospitalized patients,
including those in nephrology and medicine wards, surgical wards, and intensive
care units (ICU), and they have important metabolic and nutritional consequences.
Moreover, in case kidney replacement therapy (KRT) is started, whatever is the
modality used, the possible impact on nutritional profiles, substrate balance,
and nutritional treatment processes cannot be neglected. The present guideline is
aimed at providing evidence-based recommendations for clinical nutrition in
hospitalized patients with AKD and CKD. Due to the significant heterogeneity of
this patient population as well as the paucity of high-quality evidence data, the
present guideline is to be intended as a basic framework of both evidence and -
in most cases - expert opinions, aggregated in a structured consensus process, in
order to update the two previous ESPEN Guidelines on Enteral (2006) and
Parenteral (2009) Nutrition in Adult Renal Failure. Nutritional care for patients
with stable CKD (i.e., controlled protein content diets/low protein diets with or
without amino acid/ketoanalogue integration in outpatients up to CKD stages four
and five), nutrition in kidney transplantation, and pediatric kidney disease will
not be addressed in the present guideline.
Copyright © 2021 European Society for Clinical Nutrition and Metabolism.
Published by Elsevier Ltd.. All rights reserved.
DOI: 10.1016/j.clnu.2021.01.028
PMID: 33640205
