Anonymous User
Login / Registration

Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(5): 423–437. doi:10.14735/amgh2019423.

Nutritional diets in older gastroenterological patients with chronic kidney disease

Vladimír Teplan1,2,3, Olga Marečková4

+ Affiliation

Summary

The number of elderly patients with chronic kidney disease and another disease including gastrointestinal damage has remarkably increased over the past decades. Despite developments in dialysis technology and kidney transplantation, these approaches are unsuitable for a growing number and medical complications of elderly patients. Recently published data demonstrated successful management and positive long-term effect of special protein-restricted diet supplemented with keto amino acids in elderly. Diet management should be modified with the respect of the other underlying disease, mainly gastrointestinal pathology, and potential disorders in water and mineral metabolism. Based on our re-analysis of 3,000 patients from previous study, this approach has good compliance and a low risk of malnutrition.

Keywords

chronic kidney disease, modified restricted diet, gastrointestinal damage, old age

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users

Literature

1. Darmon P, Kaiser MJ, Bauer JM et al. Restrictive diets in the elderly: never say never again. Clin Nutr 2010; 29 (2): 170–174. doi: 10.1016/j.clnu.2009.11.002.
2. Teplan V. Metabolismus a ledviny. Praha: Grada Avicenum 2000: 35–47.
3. Brunori G, Viola BF, Parrinello G et al. Efficacy and safety of very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis 2007; 49 (5): 569–580. doi: 10.1053/j.ajkd.2007.02.278.
4. Teplan V. Funkční vyšetření ledvin u seniorů. In: Teplan V et al. Nefrologie vyššího věku. Praha: Mladá fronta, Aesculap 2015:  263–277.
5. Marečková O. Gastroenterologické komplikace u seniorů s onemocněním ledvin. In: Teplan V et al. Nefrologie vyššího věku. Praha: Mladá fronta, Aesculap 2015: 177–191.
6. Teplan V, Marečková O, Lukáš M. Onemocnění gastrointestinálního traktu a choroby ledvin. Gastroent Hepatol 2018; 72 (1): 50–57. doi: 10.14735/amgh201850.
7. Ritz E. Gastrointestinal disease and the kidney. In: Davison AM, Cameron JS, Grunfeld JP et al (eds). Oxford: Oxford University Press 1998: 2733–2735.
8. Marečkova O. Poruchy gastrointestinálního traktu u chorob ledvin. In: Teplan V. Metabolismus a ledviny. Praha: Grada 2000: 147–157.
9. Wang F, Jiang H, Shi K et al. Gut bacterial traslocation is associated with microinflammation in end-stage renal dinase patiens. Nephrology (Carlton) 2012; 17 (8): 733–738. doi: 10.1111/j.1440-1797.2012.01647.x.
10. Polak P, Jurankova J, Husa P. Struktura a funkce intestinální epiteliální bariéry. Gastroent Hepatol 2013; 67 (6): 494–497.
11. Vaziri ND, Goshtasbi N, Yuan J et al. Uremic plasma impairs barrier function and depletes the tight junction protein constituents of intestinal epithelium. Am J Nephrol 2012; 36 (5): 438–443. doi: 10.1159/000343886.
12. Marečková O, Teplan V, Schück O. Gastroenterologická problematika v nefrologii. Praha: Galen 2008.
13. Antoš F. Divertikulární choroba tlustého střeva. In: Mařatka Z (ed) et al. Gastroenterologie. Praha: Karolinum 1999: 305–309.
14. Shaheen NJ, Hansen RA, Morgan DR et al. The burden of gastrointestinal and liver diseases. Am J Gastroenterol 2006; 101 (9): 2128–2130. doi: 10.1111/j.1572-0241.2006.00723.x.
15. Lederman ED, McCoy G, Conti DJ et al. Diverticulitis and polycystic kidney disease. Am Surg 2000; 66 (2): 200–203.
16. Whiteway J, Morson BC. Elastosis in diverticular disease of the sigmoid colon. Gut 1985; 26 (3): 258–266. doi: 10.1136/gut.26.3.258.
17. Wess L, Eastwood MA, Wess TJ et al. Cross linking of collagen is increased in colonic diverticulosis. Gut 1995; 37 (1): 91–94. doi: 10.1136/gut.37.1.91.
18. Shahedi K, Fuller G, Bolus R et al. Progression from incidental diverticulosis to acute divertikulitis. Gastroenterology 2012; 142 (5) (Suppl 1): S144. doi: 10.1016/S0016-5085 (12) 60 541-1.
19. Lederman ED, Conti DJ, Lempert N et al. Complicated diverticulitis following renal transplantation. Dis Colon Rektum 1998; 41 (5): 613–618. doi: 10.1007/bf02235270.
20. Ghassemi KA, Jensen DM. Lower GI bleeding: epidemiology and management. Curr Gastroenterol Rep 2013; 15 (7): 333. doi: 10.1007/s11894-013-0333-5.
21. Colecchia A, Vestito A, Pasqui F et al. Efficacy of long term cyclic administration of the poorly absorbed antibiotic Rifaximin in symptomatic, uncomplicated colonic diverticular disease. World J Gastroenterol 2007; 13 (2): 264–269. doi: 10.3748/wjg.v13.i2.264.
22. Stelzner M, Vlahakos DV, Milford EL et al. Colonic perforations after renal transplantation. J Am Coll Surg 1997; 184 (1): 63–69.
23. Benoit G, Moukarzel M, Verdelli G et al. Gastroiontestinal complications in renal transplantation. Transpl Int 1993; 6 (1): 45–49.
24. Matsuno T, Inagaki M, Oishi M et al. Ileocolonic complications after kidney transplantation. Transplant Proc 2000; 32 (7): 1880–1881. doi: 10.1016/s0041-1345 (00) 01474-3.
25. Toogood GJ, Gillespie PH, Gujral E. Cytomegalovirus infection and colonic perforation in renal transplant patients. Transpl Int 1996; 9 (3): 248–251.
26. Ryšavá R. Postižení gastrointestinálního traktu amyloidózou – kdy na ni myslet a jak diagnostikovat. Gastroent Hepatol 2019; 73 (2): 154–162. doi: 10.14735/amgh2019154.
27. Shimizu M, Manabe T, Matsumoto T et al. Beta 2 microglobulin haemodialysis related amyloidosis: distinctive gross features of gastrointestinal involvement. J Clin Pathol 1997; 50 (10): 873–875. doi: 10.1136/jcp.50.10.873.
28. Takahashi S, Morita T, Koda Y et al. Gastrointestinal involvement of dialysis-related amyloidosis. Clin Nephrol 1988; 30 (3): 168–161.
29. McCollum DL, Rodriguez JM. Detection, treatment, and prevention of Clostridium difficile infection. Clin Gastroenterol Hepatol 2012; 10 (6): 581–592. doi: 10.1016/j.cgh.2012.03.008.
30. Schück O. Examination of kidney function. Boston: Martinus Nijhoff Publishers l984: 218–227.
31. Nádvorníková H. Koncentrační schopnost ledvin. Praha: Avicenum 1983.
32. El Nahas AM, Bello AK. Chronic kidney  disease: the global challenge. Lancet 2005;  365 (9456): 331–340. doi: 10.1016/S0140-6736 (05) 17789-7.
33. Klahr S, Harris K. Adaptation of remnant nephrons. In: Giovannetti S (ed). Nutritional treatment of chronic renal failure. Dordrecht: Kluwer Academic Publishers Group 1989: 21–28.
34. Piccoli GB, Attini R, Vasario E et al. Vegetarian supplemented low-protein diets. A safe option for pregnant CKD patiens: report of 12 pregnancies in 11 patients. Nephrol Dial Transplant 2011; 26 (1): 196–205. doi: 10.1093/ndt/gfq333.
35. Teplan V. Pharmacological features of a keto amino acids. Am J Nephrol 2005; 25 (Suppl 1): S13–S14.
36. Aparicio M, Bellizzi V, Chauveau P et al. Keto acid therapy in predialysis chronic kidney disease patiens: final consensus. J Ren Nutr 2012; 22 (Suppl 2): S1–S24. doi: 10.1053/j.jrn.2011.09.006.
37. Toigo G, Aparicio M, Attman PO et al. Expert Working Group report on nutrition in adult patients with renal insufficiency (part 1 of 2). Clin Nutr 2000; 19 (3): 197–207. doi. 10.1054/clnu.1999.0130.
38. Toigo G, Aparicio M, Attman PO et al. Expert Working Group report on nutrition in adult patients with renal insufficiency (part 2 of 2). Clin Nutr 2000; 19 (4): 281–291. doi: 10.1054/clnu.2000.0129.
39. Mitch WE. Beneficial responses to modified diets in treating patients with chronic kidney disease. Kidney Int 2005; (Suppl 94): 133–135. doi: 10.1111/j.1523-1755.2005.09430.x.
40. Misra M, Nolph K. Efficacy and safety of very-low-protein diet in the elderly: what are the options? Am J Kidney Disease 2008; 51 (3): 530–531. doi: 10.1053/j.ajkd.2007.11.034.
41. Teplan V. Effect of keto acids on asymmetric dimethylarginine, muscle, and fat tissue in chronic kidney disease and after kidney transplantation. J Ren Nutr 2009; 19 (Suppl 5): S27–S29. doi: 10.1053/j.jrn.2009.06.007.
42. Schober-Halstenberg HJ. Keto/Amino acids in the treatment of chronic kidney disease patients: 30 years experience in 3,000 patients. Am J Nephrol 2005; 25 (Suppl 1): S1–S27.
43. Teplan V, Schück O, Malý J et al. Konzervativní léčení chronické renální insuficience (CKD 4–5) u seniorů. Aktuality v nefrologii 2010; 16 (2): 59–66.
44. Teplan V. Suplementované restriktivní diety u nemocných vyššího věku s chronickým onemocněním ledvin. Vnitř Lék 2016; 62 (Suppl 6): S88–S95.

Kreditovaný autodidaktický test