title: As we grow old: nutritional considerations for older patients on dialysis.
abstract: The number of older people on dialysis is increasing, along with a need to develop specialized health care to manage their needs. Aging-related changes occur in physiological, psychosocial and medical aspects, all of which present nutritional risk factors ranging from a decline in metabolic rate to assistance with feeding-related activities. In dialysis, these are compounded by the metabolic derangements of chronic kidney disease (CKD) and of dialysis treatment per se, leading to possible aggravation of protein-energy wasting syndrome. This review discusses the nutritional derangements of the older patient on dialysis, debates the need for specific renal nutrition guidelines and summarizes potential interventions to meet their nutritional needs. Interdisciplinary collaborations between renal and geriatric clinicians should be encouraged to ensure better quality of life and outcomes for this growing segment of the dialysis population.
authors.affiliation: Department of Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Lina
authors.initials: L
authors.lastname: Johansson
authors.affiliation: Université de Lyon, UCBL, Carmen, Department of Nephrology, Centre Hospitalier Lyon-Sud, F-69495 Pierre Bénite, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.affiliation: Division of Nephrology, Dialysis and Renal Transplantation, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bellizzi
authors.affiliation: Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chauveau
authors.affiliation: AURA Paris, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Kolko
authors.affiliation: Department of Nephrology, Dr Peset University Hospital, Valencia, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Molina
authors.affiliation: Department of Nephrology, Baskent University Hospital, Ankara, Turkey.
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.affiliation: Department of Nephrology, VUmc, Amsterdam, The Netherlands.
authors.forename: Pieter M
authors.initials: PM
authors.lastname: Ter Wee
authors.affiliation: Service of Nephrology, Hôpital du Valais, Sion and Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Teta
authors.affiliation: Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Carrero
mesh_terms: D000368:Aged; D006801:Humans; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000628:therapy*; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D019282:Wasting Syndrome / Q000209:etiology / Q000628:therapy*
keywords: elderly; geriatric; malnutrition; protein–energy wasting