Kidney Week

Abstract: PO1864

The Impact of a Nutritional-Nephrological Combined Approach (NNCA) on the Metabolic Profile and Perceived Quality of Life of CKD Patients

Session Information

• Cancer and Kidney Diseases: Nephrotoxins, RCC, and More
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

• 1500 Onco-Nephrology

Authors

• Bettiga, Arianna, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Arianna Bettiga

• Di marco, Federico, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Federico Di marco,

• Fiorio, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Francesco Fiorio,

• Vago, Riccardo, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Riccardo Vago,

• Capitanio, Umberto, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Umberto Capitanio,

• Montorsi, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Francesco Montorsi,

• Salonia, Andrea, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Andrea Salonia,

• Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Francesco Trevisani,

Background

Nutritional therapy (NT) based on controlled protein intake represents a cornerstone in the management of CKD. However the international guidelines do not precisely define an adequate protein intake for onco-nephrological patients. Aim of our study is to investigate the impact of a low-normal protein diet on metabolic profile and quality of life in CKD pts affected (CS) or not (CT) by urological non-metastatic malignancies treated with a NNCA.

Methods

103 pts were enrolled in the Urological Department at San Raffaele hospital between 2018 and 2020, screened for absence of malnutrition and administered a conventional CKD protein-controlled diet (0,7-1 g/Kg/die, 30-35 kcal/ Kg/die) including aproteic foods. Anthropometrical outcomes, lab test exams and clinical variables were examined at baseline and after 6 months. To evaluate the impact of the NNCA on perceived quality of life, a QoL-Short Form36 (SF36) questionnaire were administered to pts.

Results

The combined treatment produced eGFR and urea parameter improvements (49% of pts improved eGFR, 65% uremia) without negatively altering the anthropometrical outcomes. The nutritional status was preserved in both groups and all pts had an improvement in BMI (CS: 2.8 kg/h²; CT: 1.3 kg/h²) PA° (CS: 2.8%; CT: 1.3%), BCM/h² (CS: 1.31; CT: 0.38) and FFM/h² (CS: 0.1; CT: 2) and a decrease of WC (CS: -1.3cm; CT: -1,65cm), and ECW/ICW (CS: 0.02; CT: 0.03). The SF36 questionnaire highlighted a good perceived quality of life in subjects treated with the NNCA, even if social activities were negatively affected.

Conclusion

Our study suggests that low-normal protein high calories diet ameliorates the nephrological scenario, the metabolic complications and the nutritional perspective in uro-oncological CKD pts. Following NNCA, perceived quality of life has been pushed towards high scores and does not appear to be influenced by physical health and emotional status. Harsh clinical monitoring and food choice limitations may have increased the perception of the pathological condition, thereby increasing the sense of responsibility in adhering to the NT. All this improves the physical health, but also demotivates pts and worsens their social attitudes.