Résumé
Malnutrition poses a complex challenge for end-stage kidney disease patients on dialysis, especially hemodialysis. Various factors, such as the chronic nature of kidney disease, coexisting medical conditions, advanced age, uremia's metabolic effects, and the nature of renal replacement therapy, make hemodialysis patients vulnerable to malnutrition.
Renal replacement therapies aim to alleviate uremic disorders and protect nutritional status. However, insufficiently dosed or inadequately performed dialysis can inadvertently heighten the risk of malnutrition. This chapter's key objectives are to define protein-energy malnutrition, elucidate protein-energy imbalances in hemodialysis patients, discuss nutritional management strategies (risk stratification, optimal renal replacement therapy, and preserving kidney function), and address malnutrition through approaches including physical exercise activation.
In summary, mitigating protein-energy malnutrition is a primary challenge for hemodialysis patients, second only to preserving cardiac health. Nevertheless, several effective approaches are available.