Efectividad y seguridad del uso de alfa-cetoanálogos en el manejo de la enfermedad renal crónica avanzada: recomendaciones para la práctica clínica

Effectiveness and safety of the use of alpha-keto analogues in the management of advanced chronic kidney disease: clinical practice recommendations

Autores/as

DOI:

https://doi.org/10.22265/acnef.8.1.465

Palabras clave:

fallo renal crónico , insuficiencia renal crónica , nutrición

Resumen

Introducción:
La dieta con restricción de proteínas parece tener un papel importante en la progresión de la enfermedad renal crónica (ERC) y la aparición anticipada de síntomas urémicos, además la suplementación de aminoácidos esenciales ofrece aparente seguridad para lograr restricciones agresivas de proteínas.

Objetivo:
Realizar una revisión de la literatura para establecer las recomendaciones de uso práctico sobre la dieta con restricción de proteínas en la ERC avanzada.

Materiales y métodos:
Se realizó una búsqueda estructurada rápida de la literatura en la que se incluyeron revisiones sistemáticas y metaanálisis, de los cuales se extrajeron las respuestas de las preguntas con estructura PICOT diseñadas a priori. Los resultados fueron sometidos a consenso para generar recomendaciones prácticas.

Resultados:
Se incluyeron 6 revisiones sistemáticas de la literatura con una evaluación de calidad moderada. Según los hallazgos, una dieta muy baja en proteínas con suplementación de alfacetoanálogos beneficia a los pacientes que ingresan a diálisis o son sometidos a trasplante renal, además reduce la progresión de la enfermedad. No obstante, se requiere de ensayos clínicos con mejor calidad que consideren aspectos como la calidad de vida.

Conclusión:
Aunque la evidencia es de baja calidad, se establece que la dieta muy baja en proteínas y suplementada con alfa-cetoanálogos en pacientes adecuadamente seleccionados reduce el deterioro de la tasa de filtración glomerular y parece reducir el ingreso a diálisis. Por tanto, se recomienda hacer un seguimiento estricto y periódico en el que se vigilen las medidas antropométricas y el perfil de riesgo de desnutrición.

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Referencias

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Publicado

2020-11-05

Cómo citar

1.
Ramírez Marmolejo R, Aroca G, González González CA, Pertuz A, Collazos Rozo JM, Galeano JA, Mercado Juri Álvaro. Efectividad y seguridad del uso de alfa-cetoanálogos en el manejo de la enfermedad renal crónica avanzada: recomendaciones para la práctica clínica: Effectiveness and safety of the use of alpha-keto analogues in the management of advanced chronic kidney disease: clinical practice recommendations. Rev. Colomb. Nefrol. [Internet]. 5 de noviembre de 2020 [citado 22 de septiembre de 2021];8(1):e465. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/465

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