Clinical nutrition ESPEN最新文献

{"title":"Does nutritional support prevent severe mucositis in patients with head and neck cancer treated with chemoradiotherapy?A systematic review and meta-analysis.","authors":"Aleksandra Krzywon, Anna Kotylak, Tomasz Rutkowski","doi":"10.1016/j.clnesp.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.02.007","url":null,"abstract":"<p><strong>Background: </strong>For patients with advanced head and neck cancer (HNC) chemoradiotherapy (CHRT) is the main treatment option. CHRT is a severe treatment with a high ratio of side effects which may be even more pronounced due to mucosities related malnutrition. Nutritional intervention like nutritional counseling (NC) and oral nutritional supplements (ONS) may prevent malnutrition. A systematic review and meta-analysis was performed to assess the effect of NC with or without ONS (NC±ONS) on CHRT-related grade ≥3 mucositis in patients with HNC undergoing CHRT.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Web of Science, and Scopus were searched to identify randomized and non-randomized clinical studies of HNC patients undergoing CHRT, where mucositis grade ≥ 3 data were provided. Comparative and proportional meta-analyses were performed to calculate the odds ratio (OR) and incidence of a mucositis grade ≥3 in the included studies (%) with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>There were seven studies fulfilling inclusion criteria with 655 participants included. NC±ONS revealed no risk reduction of grade ≥3 mucositis (OR: 1.2, 95%CI: 0.7 - 1.9). The overall mucositis rate was 38.3% (95%CI: 24.8%- 52.6%) and 32.8% (95% CI: 14.9%-53.5%) (p=0.67) in NC+ONS and NC-ONS respectively.</p><p><strong>Conclusion: </strong>Despite the undeniable role of NC±ONS for patients with HNC undergoing CHRT, we found it insufficient to avoid grade ≥3 CHRT-related mucositis. Further research should be conducted to determine recomendations how to decrease the risk of oral mucosities and, in consequence, how to prevent malnutrition in patients with CHRT.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to “Comment on “Lifestyle aspects are associated 1 with common mental disorders in women over 40 years older in a population-based study” Clinical Nutrition ESPEN 2024”","authors":"João Valentini Neto,&nbsp;Amália Almeida Bastos,&nbsp;Marcelo Macedo Rogero,&nbsp;Regina Mara Fisberg,&nbsp;Sandra Maria Lima Ribeiro","doi":"10.1016/j.clnesp.2025.02.006","DOIUrl":"10.1016/j.clnesp.2025.02.006","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 409-410"},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bromelain and liver health: A comprehensive systematic review of preclinical studies","authors":"Irislene Costa Pereira ,&nbsp;Álina Mara Carvalho Pedrosa-Santos ,&nbsp;Jorddam Almondes Martins ,&nbsp;Athanara Alves de Sousa ,&nbsp;Taline Alves Nobre ,&nbsp;Lucillia Rabelo de Oliveira Torres ,&nbsp;Felipe Cavalcanti Carneiro da Silva ,&nbsp;Juliana Soares Severo ,&nbsp;João Marcelo de Castro e Sousa ,&nbsp;Francisco Leonardo Torres-Leal","doi":"10.1016/j.clnesp.2025.02.001","DOIUrl":"10.1016/j.clnesp.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Liver diseases pose a significant challenge to the well-being of the public, given their high prevalence and the potential to escalate to liver failure and hepatocellular carcinoma. The efficacy of current therapies is rather limited, resulting in the manifestation of severe side effects. Bromelain, derived from the pineapple plant, exhibits promising prospects for the treatment of inflammatory disorders, cancer, and wound healing, although its impact on liver functionality remains largely unexplored.</div></div><div><h3>Objective</h3><div>To evaluate the efficiency of bromelain in liver injuries, we performed a systematic review of preclinical studies.</div></div><div><h3>Method</h3><div>Our search was conducted in August 2020 on PubMed and Scopus, employing the search terms “Liver disease,” “Liver injury,” and “Bromelain,” with subsequent updates in December 2023.</div></div><div><h3>Results</h3><div>Out of the 329 articles that were examined, only 7 fulfilled the criteria for inclusion.</div></div><div><h3>Conclusion</h3><div>Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism. In summary, bromelain demonstrates a capacity to enhance liver function across a range of injury types.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 437-445"},"PeriodicalIF":2.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving 30-day mortality after radiologically inserted gastrostomy tube from 2007 to 2019: A population-based study of 15,605 patients","authors":"Syed Shezal Hussain ,&nbsp;Nosheen Umar ,&nbsp;Umair Kamran ,&nbsp;Benjamin Coupland ,&nbsp;Fumi Varyani ,&nbsp;Nigel Trudgill","doi":"10.1016/j.clnesp.2025.01.061","DOIUrl":"10.1016/j.clnesp.2025.01.061","url":null,"abstract":"<div><h3>Background and aims</h3><div>Radiologically inserted gastrostomy (RIG) allows long-term enteral nutrition when percutaneous endoscopic gastrostomy (PEG) tube insertion is not feasible either due to technical difficulty or a higher risk of complications. The aims of this study were to examine mortality associated with RIG insertion.</div></div><div><h3>Methods</h3><div>Adult patients with RIG insertion from 2007 to 2019 were identified in the Hospital Episode Statistics database. Indications and adverse events were identified using International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. Provider nutrition support data were available from the Getting It Right First Time in Gastroenterology Report 2021. Multivariable logistic regression analysis examined factors associated with 30-day mortality following a RIG.</div></div><div><h3>Results</h3><div>15,605 patients were studied (68.0 % male; age 64(Interquartile range (IQR) 56–73)). There was a steady increase in the number of RIGs inserted from 510 per year in 2007 to 1787 per year in 2019. 59.9 % of RIGs were inserted as an outpatient. 63.3 % of RIGs were inserted in head and neck cancer patients.</div><div>Of the patients who had a RIG insertion, 4.7 % had pneumonia within 7 days and 6.9 % died within 30 days of RIG insertion. Thirty-day mortality fell from 12.2 % in 2007 to 5.8 % in 2019. Higher 30-day mortality rates were observed in patients with Dementia (16.4 %) and in NHS providers without a nutrition support nurse (11.5 %).</div><div>Factors associated with 30 day mortality included: increasing age (&gt;81 years odds ratio (OR) 13.67 (95 % confidence interval (CI) 4.99–37.48), p &lt; 0.001); increasing NHS provider volume of RIG insertion &gt;12 per year (OR 0.69 (95 % CI (0.55–0.88), p = 0.003); RIG insertion during an emergency admission (OR 2.53 (95 % CI 2.19–2.93), p &lt; 0.001); increasing comorbidity Charlson score &gt;5 (OR 1.38 (95 % CI 1.10–1.75), p = 0.006); NHS provider without a nutrition support nurse (OR 1.38 (95%CI 1.09–1.75), p = 0.007) and other neurological conditions than stroke as indication for RIG (OR 1.55 (95%CI 1.24–1.95), p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Despite an increase in RIG insertion over the study period, 30-day mortality has fallen by 52 %. Providers without a nutrition support nurse and providers with a lower volume of RIG insertions were associated with higher mortality.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 381-389"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease - Epidemiology collaboration equations even using cystatin C overestimate renal function in patients with chronic intestinal failure on long-term parenteral nutrition","authors":"Georges Kosmadakis ,&nbsp;Laurence Derain-Dubourg ,&nbsp;Madeleine Lauverjat ,&nbsp;Charlotte Bergoin ,&nbsp;Sandrine Lemoine ,&nbsp;Cécile Chambrier","doi":"10.1016/j.clnesp.2025.01.059","DOIUrl":"10.1016/j.clnesp.2025.01.059","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Accurate determination of renal function is of utmost importance in chronic intestinal failure (CIF) patients on parenteral nutrition (PN) and creatinine based glomerular filtration rate (GFR) estimating equation is used in clinical practice. The aim of the present study is to evaluate the reliability of 3 CKD-EPI GFR estimating equations (eGFR) (creatinine, cystatin C or combined creatinine/cystatin C) compared with the reference method which is Iohexol plasma clearance (mGFR) in patients on long-term PN (&gt;6 months) owing to CIF.</div></div><div><h3>Methods</h3><div>Forty-eight patients (25 F) with a median age of 58 years (Interquartile Range:15) presenting CIF on PN for a median duration of 93 months (75) were included in this retrospective study. Concordance studies were performed by Pearson correlation and Bland–Altman method (Mean bias-Confidence Interval). Accuracy of the formulas was estimated with P30 representing the proportion of eGFR within 30 % of mGFR (±30 %).</div></div><div><h3>Results</h3><div>Median mGFR was 65 (29) ml/min/1.73 m² and the median eGFR was 85 (43) ml/min/1.73 m² with 2009 CKD-EPIcreatinine, 74 (47) ml/min/1.73 m² with 2012 CKD-EPIcystatin and 75 (48) ml/min/1.73 m² with 2012 CKD-EPIcombined Cystatin C/Creatinine based formulas. The agreements were not acceptable for clinical practice. Median bias as well as lower and upper confidence intervals were for mGFR vs. eGFR (2009 CKD-EPIcreat): +21,1 (16.7,25.3), for mGFR vs. eGFR (2012 CKD-EPIcyst): +14.4 (12.9,20.5) and for mGFR vs. eGFR (2012 CKD-EPIcomb): +9.3 (7.9,15.5). Accuracy of all formulas estimated by P30 was less than 80 %. With the 3 eGFR equations, more than 46 % of patients were poorly stratified according to the classification of chronic kidney disease (CKD) with an overall tendency towards underestimation of the disease severity. Forty-seven percent of the patients had mGFR&lt;60 ml/min/1.73 m² corresponding to CKD Stage III or worse.</div></div><div><h3>Conclusions</h3><div>The eGFR estimating CKD-EPI equations significantly miscalculate the true levels of renal function in patients with CIF on PN and should be used with caution in daily clinical practice.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 390-396"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of acute bouts of exercise in fasted vs. fed states on glucose and lipid metabolism in healthy adults: A systematic review and meta-analysis of randomized clinical trials","authors":"Fatemeh Kazeminasab ,&nbsp;Pegah Rafiee ,&nbsp;Maryam Miraghajani ,&nbsp;Heitor O. Santos ,&nbsp;Michael E. Symonds ,&nbsp;Sara K. Rosenkranz","doi":"10.1016/j.clnesp.2025.02.002","DOIUrl":"10.1016/j.clnesp.2025.02.002","url":null,"abstract":"<div><h3>Aims</h3><div>Exercise while fasted is often promoted as beneficial for lipid metabolism, as it may confer superior metabolic adaptations compared with exercise performed in the fed state. The aim of this systematic review and meta-analysis was to determine the effects of acute exercise in fasted versus fed states on glucose and lipid metabolism in healthy adults.</div></div><div><h3>Data extraction</h3><div>A systematic review and meta-analysis was performed by searching PubMed, Scopus, and Web of Science databases up to July 2023, for randomized clinical trials that determined the effects of exercise in fasted vs. fed states on glucose and lipid metabolism (serum glucose, insulin, triacylglycerol, free fatty acid (FFA) concentrations, and respiratory exchange ratio (RER)) in healthy adults. Meta-analyses were conducted to determine weighted mean differences (WMD) and 95 % confidence intervals.</div></div><div><h3>Analysis</h3><div>The current meta-analysis included 28 studies with a total sample of 302 healthy adults, with exercise durations ranging from 36 to 150 min. Acute exercise performed while fasted was associated with significant increases from pre- to post-exercise in fasted serum glucose [WMD = 0.263 mmol/L, p = 0.009] and insulin [WMD = 8.84 mU/mL, p = 0.001], and significantly decreases in FFA [WMD = −0.121 mmol/L, p = 0.019] when compared with exercise in the fed state. However, no significant differences were reported for changes in triacylglycerol or RER from pre- to post-exercise when comparing fasted vs. fed states.</div></div><div><h3>Conclusion</h3><div>When compared with exercise in the fed state, exercise performed while fasted was associated with larger increases in glucose and insulin levels, along with larger decreases in FFA levels. Thus, our results do not suggest that acute fasted exercise is necessarily better for glucose or lipid metabolism when compared with exercise performed in the fed state. It is possible, albeit unlikely, that acute bouts of exercise performed while fasted may result in some degree of metabolic impairment.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 320-331"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A high prevalence of stunting was observed among under-five children: A community-based cross-sectional study","authors":"Sileshi Mulatu ,&nbsp;Azeb Gedif ,&nbsp;Fikir Tadesse ,&nbsp;Workie Zemene ,&nbsp;Mengstu Berhanu ,&nbsp;Hailemariam Mekonnen Workie","doi":"10.1016/j.clnesp.2025.01.060","DOIUrl":"10.1016/j.clnesp.2025.01.060","url":null,"abstract":"<div><h3>Background</h3><div>In low-income countries, stunting remains a major public health problem. It contributes to 50 % of all morbidity and mortality of under-five children and results in diminished mental and physical development.</div></div><div><h3>Objectives</h3><div>This study aims to determine the prevalence of stunting and identify the key socio-demographic, clinical, and environmental factors that associated with stunting among children aged 6–59 months in Pawie District, Ethiopia.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional study was conducted from March 1st to April 1st, 2019 among 841 children aged 6–59 months. An anthropometric measurement was taken for all children to determine their nutritional status, but demographic, clinical, and associated factor data were obtained through face-to-face interviews with the mother of the child using a structured questionnaire. Before analysis, the data was cleaned thoroughly to check for completeness. Then, enter into Epi Info version 7 and export to SPSS v25 for analyses. Frequencies mean, SD, percentage, and cross-tabulations were used to summarize the descriptive statistics of the data. Bi-variable and multi-variable logistic regression was employed to identify the associated factors of stunting. Lastly, results were presented using tables, charts, graphs, and result statements.</div></div><div><h3>Results</h3><div>A total of 841 respondents were included in this study, with a 99 % response rate. The prevalence of stunting among children aged 6–59 months was 37.2 % (95 % CI: 33.9–40.4). Of these, half (50.1 %) were female. Child age (AOR = 1.988 [95 % CI: 1.140, 3.465]), maternal education (AOR = 5.164 [95 % CI: 1.207, 22.099]), maternal occupation (AOR: 4.975 [95 % CI: 1.720, 14.385]), episodes of malaria (AOR = 1.900 [95 % CI: 1.262, 2.862]), colostrum feeding (AOR = 2.519 [95 % CI: 1.310, 4.846]), and meal frequency (AOR = 1.857 [95 % CI: 1.084, 3.179]) were factors significantly associated with stunting.</div></div><div><h3>Conclusions</h3><div>In this study, a relatively high prevalence of stunting and many factors associated with it were observed. Therefore, confirming food security at the household level and creating awareness among mothers and guardians are the best methods to reverse under-5 stunting.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 343-351"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year survival in patients with oncological disease with low muscle reserve, risk of sarcopenia and probable sarcopenia: A post hoc analysis","authors":"Carolina Pinzón Ospina ,&nbsp;Daniela Ballen Castañeda ,&nbsp;María Paula Cubillos-Carreño ,&nbsp;Daniela Alejandra Acero Alfonso ,&nbsp;Yeny Marjorie Cuellar Fernandez ,&nbsp;Jorge Medina-Parra ,&nbsp;Montserrat Montes-Ibarra ,&nbsp;Ricardo Alfonso Merchán-Chaverra","doi":"10.1016/j.clnesp.2025.01.051","DOIUrl":"10.1016/j.clnesp.2025.01.051","url":null,"abstract":"<div><h3>Introduction</h3><div>Sarcopenia is a clinical syndrome characterized by the loss of muscle mass quantity and quality. Our objective was to establish the prevalence of low muscle reserve, risk of sarcopenia (RIS) and probable sarcopenia (PS) and their associations with survival at two years in hospitalized patients with cancer.</div></div><div><h3>Methods</h3><div>This was a post hoc analysis of the Nutri-Score and Malnutrition Screening Tool (MST) operational characteristics. Adjusted calf circumference (CC) was used as an indicator of muscle reserve. The RIS was determined using cut-off points of the CC. PS was defined as low hand grip strength (HGS) according to Working Groups on Sarcopenia also the presence of RIS with PS was analysed. A 2-year survival model was constructed.</div></div><div><h3>Results</h3><div>A total of 137 patients were included: 54 % were women, with a mean age of 54.7 ± 15.4 years; 61 % had some degree of malnutrition; 48 % had low muscle reserve; 42 % had RIS; 28 % and 38 % had PS and 25 % had RIS with PS. Severe muscle reserve deficit (Hazard Ratio (HR) = 2.71, 95 % Interval Confidence (95 % CI) 1.37–5.37), RIS (HR = 2.94 95 % 1.66–5.21), PS (HR = 1.85 95 % 1.06–3.22) and (HR = 1.94 95 % 1.09–3.41) by two different consensus and RIS with PS (HR = 2.36 95 % CI 1.33–4.19) were associated with survival.</div></div><div><h3>Conclusion</h3><div>Severe muscle reserve deficit, RIS and PS are associated with decreased survival in hospitalized patients with oncological disease.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 352-360"},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehabilitation improves preoperative fitness and reduced emergency admissions post operatively.","authors":"Melissa Taylor ∗","doi":"10.1016/j.clnesp.2024.10.014","DOIUrl":"10.1016/j.clnesp.2024.10.014","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 493-494"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical nutrition in patients with Acute Kidney Injury: Traditional approaches and emerging perspectives","authors":"Francesca Di Mario ,&nbsp;Alice Sabatino ,&nbsp;Enrico Fiaccadori","doi":"10.1016/j.clnesp.2024.12.015","DOIUrl":"10.1016/j.clnesp.2024.12.015","url":null,"abstract":"<div><div>Acute kidney injury (AKI) is a complex clinical syndrome characterized by a rapid decline in kidney function, often resulting in complex metabolic and hormonal derangements. A major concern in managing AKI patients is the development of protein energy wasting (PEW), a condition marked by loss of lean body mass and negative impact on overall health outcomes. Additionally, the need of Kidney Replacement Therapy (KRT) for the most severe forms of AKI may further increase the risk of PEW, with a substantial impact on fluid and metabolic balance. Adequate nutritional support is crucial in the management of AKI, as it plays a pivotal role in muscle mass preservation, morbidity reduction and recovery of renal function.</div><div>This paper aims to evaluate the current evidence regarding nutritional strategies in AKI patients, focusing on energy and protein requirements, timing and route of nutritional intervention, and impact of individualized nutrition plans on PEW prevention and management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 348-356"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}