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

Palabras clave: falla renal crónica, insuficiencia renal crónica, nutrición, seguridad alimentaria y nutricional

Resumen

Introducción y objetivo:

La dieta con restricción de proteínas parece tener un papel importante en la progresión de la enfermedad renal crónica y la aparición anticipada de síntomas urémicos, la suplementación de aminoácidos esenciales ofrece aparente seguridad en lograr restricciones agresivas de proteínas. El objetivo de este documento es realizar una revisión de la literatura para informar recomendaciones de uso práctico sobre esta conducta en la Enfermedad Renal (ERC)avanzada.

 

Materiales y métodos:

Se realiza una búsqueda estructurada rápida de la literatura, con selección de revisiones sistemáticas y metaanálisis, de los cuales se extrae las respuestas de las preguntas con estructura PICOT diseñadas a priori. Los resultados fueron sometidos a consenso para generar unas recomendaciones prácticas.

 

Resultados:

Se incluyeron 6 revisiones sistemáticas de la literatura, con una evaluación de calidad moderada, la extracción de la información reporta un aparente beneficio de la dieta muy baja en proteínas con suplementación de alfa-cetoanálogos en el ingreso a diálisis o trasplante renal y una consistente reducción de la progresión de la enfermedad. Se requiere de mejores ensayos clínicos que integren desenlaces como calidad de vida.

 

Conclusiones:

Con baja calidad de la evidencia la dieta muy baja en proteínas, suplementado con alfa- cetoanálogos, en el paciente adecuadamente seleccionado, reduce el deterioro de la tasa de filtración glomerular, parece reducir el ingreso a diálisis. Se recomienda un seguimiento estricto periódico, con vigilancia de medidas antropométricas y perfil de riesgo de desnutrición.

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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 de práctica clínica. . Rev. Colomb. Nefrol. [Internet]. 5 de noviembre de 2020 [citado 23 de noviembre de 2020];8(1):25-9. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/465
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