title: [Evaluation of a Nutritional Intervention Program in advanced chronic kidney disease (ACKD) patients].
abstract: OBJECTIVE
  Advanced Chronic Kidney Disease (ACKD) is associated with high prevalence of malnutrition. The habitual continuous dietary restrictions used in clinical practice. increased the malnutrition risk. The aim of this study was to evaluate the effects of a Nutritional intervention Program (NIP) on renal function and nutritional status in patients with ACKD.
  
  
  METHODS
  93 patients, (53.7% men, 66±17 years) were included in a prospective longitudinal study. The patients recived a NIP during 6 months with mensual visits. At baseline and six months the outcome assessed were: nutritional status by Chang criteria, anthropometric, dietetic and biochemical parameters (albumin, prealbumin, creatinine clearance, serum phosphorus, potassium, total-Cholesterol, LDL, HDL, triglycerides, and PCR).
  
  
  RESULTS
  After intervention, caloric intake decreased in nourished patients (1833 ±318 vs. 1571±219 kcal p=.001). and it was constant in malnourished patients. The intake of protein (69,9 ± 16,6 vs 54,9 ± 11 g p < 0.001), potassium (2938 ± 949 vs 2377 ± 743 mg p < 0.001) and phosphorus (1180 ± 304 vs 946,6 ± 211 mg p < 0.001) significantly decreased. 16.5% patients required supplementation. A total of 41.7% of patients were malnourished at baseline (27.8% mild, 10.10% moderate and 3.8% severe), and 16.8% at the end (8% mild, 5% moderate and 3.8% severe) by Chang criteria. At the end of NIP, patients significantly increased creatinine clearance (17,8 ± 5,2 vs 19,4 ± 6,9 ml/min, p < 0,01), albumin (3,3 ± 0,5 vs. 3,5 ± 0,4 g/dL, p < 0,05), and decreased serum potassium (4,8 ± 0,6 vs 4,5 ± 0,5 mmol/L, p < 0,05), total cholesterol (179,8 ± 44,3 vs 170,0 ± 15,1 mg/dL, p < 0,05), LDL (113,2 ± 37,0 vs 108,3 ± 27,3 mg/dL, p < 0.01) and tryglicerides (141.9 ± 60.8 vs 129.9 ± 52.7 mg/dL, p < 0.05).\
  
  
  CONCLUSIONS
  The study reflected a NIP usefulness in the nutritional status and renal function improvements within an interdisciplinary framework during ACKD consultations.
authors: Unidad de Nutrición Clínica y Dietética. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid.. almudenapereztorres@gmail.com.
authors: Almudena
authors: A
authors: Pérez-Torres
authors: Servicio de Nefrología. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Elena
authors: E
authors: González
authors: Servicio de Nefrología. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: M Auxiliadora
authors: MA
authors: Bajo
authors: Unidad de Nutrición Clínica y Dietética. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Samara
authors: S
authors: Palma Milla
authors: Servicio de Nefrología. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Rafael
authors: R
authors: Sánchez-Villanueva
authors: Unidad de Nutrición Clínica y Dietética. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Laura María
authors: LM
authors: Bermejo
authors: Servicio de Nefrología. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Gloria
authors: G
authors: Del Peso
authors: Servicio de Nefrología. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Rafael
authors: R
authors: Selgas
authors: Unidad de Nutrición Clínica y Dietética. Hospital Universitario de La Paz. IDIPAZ. Universidad Autónoma de Madrid..
authors: Carmen
authors: C
authors: Gómez-Candela
mesh_terms: D000368:Aged; D002149:Energy Intake; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy*