Kidney Week

Abstract: TH-PO926

The Relevance of a Personalized Low-Normal Protein High-Calorie Diet in Nephrectomized Patients for Renal Cell Carcinoma (RCC): Myth or Reality?

Session Information

• Health Maintenance, Nutrition, Metabolism - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

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

Francesco Trevisani,

• Paccagnella, Matteo, Fondazione ARCO, Cuneo, Italy

Matteo Paccagnella,

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

Francesco Fiorio,

• Laurenti, Fabiana, Universita degli Studi dell'Aquila - Polo Coppito, L'Aquila, Abruzzo, Italy

Fabiana Laurenti,

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

Riccardo Vago,

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

Federico Di Marco,

• Floris, Matteo, Azienda Ospedaliera Brotzu, Cagliari, Italy

Matteo Floris,

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

Umberto Capitanio,

• Ghidini, Michele, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Michele Ghidini,

• Garrone, Ornella, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Ornella Garrone,

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

Andrea Salonia,

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

Francesco Montorsi,

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

Arianna Bettiga,

Background

Nutritional therapy (NT) based on a controlled protein intake represents a cornerstone in the management of CKD. However, if a CKD patient is at the same time affected by cancer, oncologists suggest a diet based on high protein intake to avoid malnutrition.International guidelines are not diriment in this asset of patients. In particular, no clear nutritional management is established in the radical nephrectomy (RN) patients for RCC. The aim of our study was to investigate the efficacy of a Low-Normal Protein High Calorie (LNPHC) diet in a consecutive RN cohort of RCC pts using an integrated nephrologist and nutritionist approach.

Methods

A consecutive cohort of 40 nephrectomized pts for RCC was enrolled in a tertiary institution between 2020-2022. Inclusion criteria: Age >18 years old, eGFR<60 ml/min/1.73,RN for RCC. An initial nephrological and nutritional evaluations were performed and then a conventional CKD LNPHC diet integrated with aproteic foods (0,7-1 g/Kg/die: calories: 30-35 kcal per kg body weight/die) for a period of 6 months (+/- 2 moths). MST, Body Mass Index (BMI), Phase Angle (PA), Fat Mass percentage (FM%), Fat-Free Mass Index (FFMI), body cell mass index (BCMI), extracellular/intracellular water ratio (ECW/ICW), waist/hip circumference ratio (WHC), lab test exams and clinical variables were examined at baseline and after 6 months. Statistical analysis: Kruskal-Wallis rank sum test; Data analysis: R programming language and RStudio integrated development environment.

Results

Descriptive analysis is showed in Table 1. Our results clearly highlighted that LNPHC was able to generate a significant improvement in several nutritional parameters (Tables 2 and 3). Moreover, LNPHC was responsible for a significant decrease of urea.

Conclusion

LNPHC represents a new important therapeutic strategy to apply in the onco-nephrological patients with solitary kidney due to renal cancer.