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Abstract: SA-PO135

The Impact of a Low-Normal Protein High Calorie Diet in the Onco-Nephrological Scenario: Do the Opposites Attract?

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Bettiga, Arianna, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Fiorio, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Di marco, Federico, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Liguori, Francesca, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Vago, Riccardo, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Capitanio, Umberto, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Salonia, Andrea, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Montorsi, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
Background

Nutritional therapy (NT) based on controlled protein intake represents the cornerstone when managing chronic kidney disease (CKD), however the international guidelines do not clearly definine an adequate protein intake for onco-nephrological patients. Aim of our study is to investigate the impact of a low-normal protein high calorie diet (LNPHCD) on the quality of life (QoL) and on the renal and nutritional status in a consecutive cohort of 85 nephrological pts affected or not by urological non-metastatic neoplasia treated with a nephrologist-nutritionist combined approach (NNCA).

Methods

Pts were enrolled in the Urological Department at San Raffaele hospital between 2018-2020, screened for absence of malnutrition and were administered a conventional CKD protein-controlled diet (0,7-1 g/Kg/die: calories: 30-35 kcal per kg body weight/die) for a period of 6 months. The diet was based on the CKD onco-nephrological clinical conditions and the pts’ nutritional state. Anthropometrical outcomes, lab test exams (including Iohexol test for mGFR) and clinical variables were examined at baseline and after 6 months. To evaluate the impact of the combined approach on perceived QoL, multiple 8 scale assessments in a generic QoL-Short Form36 (SF36) questionnaire were administered to each patient.

Results

The NNCA was effective in improving mGFR (Δ=+1.8) and uremia (Δ=-16), outlining its effectiveness in managing nephrological complications in the entire population, regardless of the presence of neoplasia. BIA outcomes showed significant improvement, especially when the parameters were malnutrition-related (MR) (ΔPhA=+0.1°; ΔBCMI=+0.5; ΔFFMI=+0.5). The SF36 questionnaire highlighted a good perceived QoL in subjects treated with the NNCA, even if social activities were negatively affected.

Conclusion

Our work demonstrated that LNPHCD, as part of a multidisciplinary approach, ameliorates not only the nephrological scenario in this asset of patients but above all the MR parameters, while maintaining a high QoL and a healthy nutritional status. Following NNCA treatment, perceived QoL has improved and does not appear to be influenced by physical health and emotional status. Despite this, we observed that social activities are greatly and negatively affected.