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Abstract
The prevalence of malnutrition in patients with Chronic Kidney Disease is high, increasing in patients with SARS-CoV-2 infection. The relationship between inflammation and nutrition in kidney disease is known, so the previous presence of malnutrition conditions worsens the prognosis of infection.
The objective of this article is the creation of specific dietary recommendations for patients with chronic kidney disease and infection or post-infection by the SARS-CoV-2 virus, adapted to the stage of the disease and the stage of the infection process.
The nutritional approach begins with the assessment of nutritional status, recommending minimizing physical contact through the use of the Global Leadership Initiative on Malnutrition (GLIM) criteria and the rapid sarcopenia questionnaire (SARC-F).
The dietary recommendations should consider the stage of chronic kidney disease, the stage of infection by SARS-CoV-2 and the complications arising that compromise oral intake, among the most common are: anorexia, ageusia, dysphagia and diarrhea. In this document, tables of daily intakes have been prepared adapted to different situations. In those patients who do not meet the nutritional requirements, it is recommended to start with an early nutritional supplementation, considering the consequences of the infection described.
Due to the high risk of malnutrition in patients with chronic kidney disease and SARS-CoV-2 infection, it is recommended to adapt the assessment of nutritional status and treatment, as well as to carry out monitoring after the active infection phase.
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References
- Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv 2020: Feb. [En prensa].
- Li Z, Wu M, Yao J, Guo J, Liao X, Song S, et al. Caution on Kidney Dysfunctions of COVID-19 Patients. MedRxiv 2020 Feb. [En prensa].
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061-9.
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395:507-13.
- Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382:1708-20.
- Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clinical Nutrition. 2020;39:1631-8.
- Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38:1-9.
- Malmstrom TK, Morley JE. SARC-F: A Simple Questionnaire to Rapidly Diagnose Sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-2.
- Aranceta J, Arija V, Maíz E, Martinez E, Ortega R, Pérez-Rodrigo Cetal. Guías alimentarias para la poblaciónespañola (SENC, 2016); la nueva pirámide de la alimentación saludable. Nutr Hosp. 2016;33(Supl. 8):1-48.
- Wright M, Southcott E, MacLaughlin H, Wineberg S. Clinical practice guideline on undernutrition in chronic kidney disease. BMC Nephrol. 2019;20:370.
- Clinical Practice Guideline for Nutrition chronic Kidney Disease: 2019 UPDATE. National Kidney Foundaiton NKF). [Consultado 2 May 2020]. Disponible en: https://www.kidney.org/sites/default/files/Nutrition_GL%2BSubmission_101719_Public_Review_Copy.pdf.
- Jin Y-H, Cai L, Cheng Z-S, Cheng H, Deng T, Fan Y-P, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7:4.
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2017;7:1-59.
- Posición de expertos sobre el manejo nutricional del coronavirus COVID 19. Comité Internacional para la Elaboración de Consensos y Estandarización en Nutriología (CIENUT). Abril 2020. [Consultado 2 May 2020]. Disponible en: https://cienut.org/comite_internacional/declaraciones/pdf/declaracion2.pdf.
- Lomax AR, Calder PC. Prebiotics, immune function, infection and inflammation: a review of the evidence. Br J Nutr. 2009; 101:633-58.
- Zhang L, Liu Y. Potenial al interventions for novel coronavirus in China: a systematic review. J Med Virol. 2020; 92:479-90.
- Hyun YY, Lee KB, Han SH, Kim YH, Kim YS, Lee SW, et al. Nutritional Status in Adults with Predialysis Chronic Kidney Disease: KNOW-CKD Study. J Korean Med Sci. 2017 Feb;32(2):257-63.
- Tao Li, Yalan Zhang, Cheng Gong, Jing Wang, Bao Liu, Li Shi and Jun Duan Eur J Clin Nutr. 2020;74(6):871-5.
- Kalantar-Zadeh and Moore. Impact of Nutrition and Diet on COVID-19 Infection and Implications for Kidney Health and Kidney Disease Management. J Ren Nutr. 2020;30(3):179-81.
- Handu D, Moloney L, Rozga M, Cheng F. Malnutrition Care during the COVID-19 Pandemic: Considerations for Registered Dietitian Nutritionists Evidence Analysis Center. J Acad Nutr Diet. 2020 may. [En prensa].
- Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562.
- Caccialanza R, Laviano A, Lobascio F, Montagna E, Bruno R, Ludovisi S, et al. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol. Nutrition 2020 abr. [En prensa].
- Watanabe H, Enoki Y, Maruyama T. Sarcopenia in Chronic Kidney Disease: Factors, Mechanisms, and Therapeutic Interventions. Biol Pharm Bull. 2019; 42(9):1437-45.
- Morley JE, Kalantar-Zadeh K, Anker SD. COVID-19: a major cause of cachexia and sarcopenia? J Cachexia Sarcopenia Muscle. 2020 Aug; 11(4): 863–5.
- Rovere Querini P, De Lorenzo R, Conte C, et al. Post-COVID-19 follow-up clinic: depicting chronicity of a new disease. Acta Biomed. 2020;91(9-S):22-8.
References
Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv 2020: Feb. [En prensa].
Li Z, Wu M, Yao J, Guo J, Liao X, Song S, et al. Caution on Kidney Dysfunctions of COVID-19 Patients. MedRxiv 2020 Feb. [En prensa].
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061-9.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395:507-13.
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382:1708-20.
Barazzoni R, Bischoff SC, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clinical Nutrition. 2020;39:1631-8.
Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38:1-9.
Malmstrom TK, Morley JE. SARC-F: A Simple Questionnaire to Rapidly Diagnose Sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-2.
Aranceta J, Arija V, Maíz E, Martinez E, Ortega R, Pérez-Rodrigo Cetal. Guías alimentarias para la poblaciónespañola (SENC, 2016); la nueva pirámide de la alimentación saludable. Nutr Hosp. 2016;33(Supl. 8):1-48.
Wright M, Southcott E, MacLaughlin H, Wineberg S. Clinical practice guideline on undernutrition in chronic kidney disease. BMC Nephrol. 2019;20:370.
Clinical Practice Guideline for Nutrition chronic Kidney Disease: 2019 UPDATE. National Kidney Foundaiton NKF). [Consultado 2 May 2020]. Disponible en: https://www.kidney.org/sites/default/files/Nutrition_GL%2BSubmission_101719_Public_Review_Copy.pdf.
Jin Y-H, Cai L, Cheng Z-S, Cheng H, Deng T, Fan Y-P, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7:4.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2017;7:1-59.
Posición de expertos sobre el manejo nutricional del coronavirus COVID 19. Comité Internacional para la Elaboración de Consensos y Estandarización en Nutriología (CIENUT). Abril 2020. [Consultado 2 May 2020]. Disponible en: https://cienut.org/comite_internacional/declaraciones/pdf/declaracion2.pdf.
Lomax AR, Calder PC. Prebiotics, immune function, infection and inflammation: a review of the evidence. Br J Nutr. 2009; 101:633-58.
Zhang L, Liu Y. Potenial al interventions for novel coronavirus in China: a systematic review. J Med Virol. 2020; 92:479-90.
Hyun YY, Lee KB, Han SH, Kim YH, Kim YS, Lee SW, et al. Nutritional Status in Adults with Predialysis Chronic Kidney Disease: KNOW-CKD Study. J Korean Med Sci. 2017 Feb;32(2):257-63.
Tao Li, Yalan Zhang, Cheng Gong, Jing Wang, Bao Liu, Li Shi and Jun Duan Eur J Clin Nutr. 2020;74(6):871-5.
Kalantar-Zadeh and Moore. Impact of Nutrition and Diet on COVID-19 Infection and Implications for Kidney Health and Kidney Disease Management. J Ren Nutr. 2020;30(3):179-81.
Handu D, Moloney L, Rozga M, Cheng F. Malnutrition Care during the COVID-19 Pandemic: Considerations for Registered Dietitian Nutritionists Evidence Analysis Center. J Acad Nutr Diet. 2020 may. [En prensa].
Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562.
Caccialanza R, Laviano A, Lobascio F, Montagna E, Bruno R, Ludovisi S, et al. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol. Nutrition 2020 abr. [En prensa].
Watanabe H, Enoki Y, Maruyama T. Sarcopenia in Chronic Kidney Disease: Factors, Mechanisms, and Therapeutic Interventions. Biol Pharm Bull. 2019; 42(9):1437-45.
Morley JE, Kalantar-Zadeh K, Anker SD. COVID-19: a major cause of cachexia and sarcopenia? J Cachexia Sarcopenia Muscle. 2020 Aug; 11(4): 863–5.
Rovere Querini P, De Lorenzo R, Conte C, et al. Post-COVID-19 follow-up clinic: depicting chronicity of a new disease. Acta Biomed. 2020;91(9-S):22-8.