3 IntroductionHigh prevalence of malnutrition exists in patients with CKD.Several surveys have reported protein-calorie malnutrition in up to 40% of CKD pts.Risk for malnutrition increases as CKD progresses.Malnutrition in CKD is multifactors.Surveys consistently report inadequate oral intake >>>major contributing factor.Ann Rev Nutr, 2001;21:
4 Nutritional Challenges in CKD Undernourished patients with ESRDSignificantly increased morbidity : 27% - 43% increased risk for strokeIndependently associated with increased mortality.-Results in more & longer hospitalizations& higher health care costs.Negatively affects functioning & quality of life
5 Serum albumin concentration and survival in patients with nondialysis-dependent CKD Am. J. Clin. Nutr. 90, 407–414 (2009).
7 Protein-Energy Malnutrition (PEM) a lack of adequate energy or protein supply that meets the metabolic demands placed on the body by one or more of the following:• inadequate protein intake from dietary sources• ingestion of poor quality protein• increased demands resulting from disease• increased loss of nutrients