ESPEN practical guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease
Open accessAbstract
BACKGROUND AND AIMS: Hospitalized patients often have acute kidney disease (AKD) or chronic kidney disease (CKD), with important metabolic and nutritional consequences. Moreover, in case kidney replacement therapy (KRT) is started, the possible impact on nutritional requirements cannot be neglected. On this regard, the present guideline aims to provide evidence-based recommendations for clinical nutrition in hospitalized patients with KD. METHODS: The standard operating procedure for ESPEN guidelines was used. Clinical questions were defined in both the PICO format, and organized in subtopics when needed, and in non-PICO questions for the more general topics. The literature search was from January 1st, 1999 until January 1st, 2020. Each question led to one or more recommendation/statement and related commentaries. Existing evidence was graded, as well as recommendations and statements were developed and agreed upon in a multistage consensus process. RESULTS: The present guideline provides 32 evidence-based recommendations and 8 statements, defining how to assess nutritional status, how to define patients at risk, how to choose the route of feeding, and how to integrate nutrition with KRT. In the final online voting, a strong consensus was reached in 84% at least of recommendations and 100% of statements. CONCLUSION: The presence of KD in hospitalized patients identifies a highly heterogeneous group of subjects with widely varying nutrient needs and intakes. Considering the high nutritional risk related with this clinical condition, an individualized approach consisting of nutritional status evaluation and monitoring, frequent evaluation of nutritional requirements, and careful integration with KRT should be planned to avoid both underfeeding and overfeeding. Practical recommendations and statements were developed, aiming at defining suggestions for everyday clinical practice in the individualization of nutritional support in this patient setting. Literature areas with scarce or without evidence were also identified, thus requiring further basic or clinical research.
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Phosphate supplementation for hypophosphatemia during continuous renal replacement therapy in adults
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Flagged first, then by citations
Research works printed but not linked: 1
- 2012, KDIGO clinical practice guideline for acute kidney injury, Kidney Int, 2, 1
Cited by
Still being checked.
- Authors
- Sabatino, A., Fiaccadori, E., Barazzoni, R., Carrero, J. J., Cupisti, A., De Waele, E., Jonckheer, J., Cuerda, C., & Bischoff, S. C.
- Affiliations
- Karolinska Institutet (SE)
- University of Parma (IT)
- University of Trieste (IT)
- University of Pisa (IT)
- Vrije Universiteit Brussel (BE)
- Universidad Complutense de Madrid (ES)
- University of Hohenheim (DE)
- Corresponding author
- Sabatino, Alice
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2024-09
- Volume
- 43
- Issue
- 9
- Pages
- 2238-2254
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W4401747778
- Semantic Scholar
- 6e3b4e4b643898bf6ef44efa13c2be4fa1e0fa9b
- Cited by
- 40
- References
- 232
- Citations by year
- 2026: 23 · 2025: 13 · 2024: 4
- FWCI
- 9.14
- Type
- journal article
- Language
- en
- Update notices
- erratum (2024-10-01)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Nutrition (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc-nd)
- Funders
- European Society for Clinical Nutrition and Metabolism
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- acute kidney disease, chronic kidney disease, hospitalized patients, nutritional assessment, nutritional risk, renal replacement therapy, enteral nutrition, parenteral nutrition, individualized nutritional support, nutrient requirements
- MeSH terms
- Hospitalization, Humans, Nutritional Requirements, Nutritional Status, Nutrition Assessment, Renal Replacement Therapy, Nutritional Support, Nutrition Therapy, Renal Insufficiency, Chronic, Acute Kidney Injury
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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