Nutritional rehabilitation of elderly and senile patients with non-dialysis chronic kidney disease. Case report
Abstract
A low-protein diet has traditionally been used to mitigate the progression of uremic symptoms and to decrease the production of nitrogen-catabolism products in patients with chronic kidney disease (CKD). CKD is prevalent among individuals over 65, and its progression leads to a decline in nutritional status, particularly in protein-energy deficiency, muscle weakness, and functional limitations. These issues are further exacerbated by aging. Malnutrition is regarded as a significant factor in the multifactorial causes of sarcopenia and senile asthenia. Eating disorders in elderly and senile patients are associated with an increased incidence of infections, prolonged and more frequent hospitalizations, extended recovery times, elevated fracture risks, dependency on external assistance, a decline in quality of life, and a higher mortality rate. This situation necessitates the implementation of appropriate medical rehabilitation strategies that consider the complexities of comorbidity and nutritional disorders in these patients. The mechanisms that drive the development of CKD and various geriatric syndromes, such as malnutrition, sarcopenia, and falls, are intricate. They include metabolic acidosis, oxidative stress, overproduction of pro-inflammatory cytokines, secondary hyperparathyroidism, decreased vitamin D levels, and chronic anemia, all of which contribute to reduced physical activity and diminished food intake. Given such complex mechanisms, nutritional support and…
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