Archivos suplementarios
Palabras clave
Insuficiencia renal
suplementos dietarios
zinc
ácidos grasos
ácido fólico
proteínas.
suplementos dietarios
zinc
ácidos grasos
ácido fólico
proteínas.
Cómo citar
1.
Arreaza-Kaufman D, Rueda-Rodríguez MC, Tassinari S, Mosos JD, Castañeda-Cardona C, Rosselli D. Suplementos nutricionales en enfermedad renal crónica. Rev. Colomb. Nefrol. [Internet]. 18 de noviembre de 2016 [citado 3 de julio de 2024];3(2):89-98. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/230
Resumen
Introducción: El estado nutricional de los pacientes con enfermedad renal crónica (ERC) influye sobre el progreso de la enfermedad y se asocia al incremento en el riesgo cardiovascular. Revisamos en la literatura el efecto de los suplementos nutricionales en estos pacientes.
Métodos: Se realizó una búsqueda de la literatura en las bases de datos electrónicas Pubmed y Embase para encontrar estudios clínicos que relacionaran el efecto de los suplementos y/o complementos nutricionales con ERC.
Resultados: De 353 artículos que resultaron inicialmente, se seleccionaron 26, de los cuales 23 fueron realizados en población con falla renal. En los pacientes con suplencia, se reportaron efectos como disminución en los niveles de homocisteína tras la administración de zinc, omega-3 y ácido fólico. Adicionalmente, se evidenció disminución en los metabolitos de estrés oxidativo. Con la terapia de suplementación con vitamina D se observó mejoría en el perfil lipídico y diminución en hemoglobina glicosilada y PCR.
Discusión: Los suplementos y/o complementos nutricionales compuestos por probióticos, ácidos grasos de cadena larga (omega-3), proteínas, elementos de traza, antioxidantes y ácido fólico podrían ser de importancia en pacientes con ERC ante los efectos benéficos que han demostrado tener, por la reducción en la homocisteína y otros factores derivados del estrés oxidativo considerados marcadores de riesgo cardiovascular, o también por disminuirse la prevalencia de malnutrición en esta población. Los estudios sugieren que los suplementos y/o complementos nutricionales podrían retrasar el deterioro renal progresivo y reducir los marcadores de riesgo cardiovascular, principalmente en aquellos compuestos por omega-3.
Citas
1. Echeverri J, Huérfano M, López V, Calderón A, Vargas J, Camargo A, et al. Experiencia del Día Mundial del Riñón 2013 en el Hospital Militar Central de Bogotá: Síndrome metabólico y enfermedad renal. Rev Colomb Nefrol. 2014; 1(1): 10-6.
2. Snyder J, Foley R, Collins A. Prevalence of CKD in the United States: a sensitivity analysis using the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Am J Kidney Dis. 2009; 53(2): 218-28.
3. Eknoyan G, Lameire N, Eckardt K-U, Kasiske B, Wheeler D, Willis K, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013; 3(1): 1-150.
4. Rosselli D, Tarazona N, Aroca A. La salud en Colombia 1953-2013: Un análisis de estadísticas vitales. Med. 2014; 36(2): 120-35.
5. Cantillo J, Madera AM. Importancia del control de los factores de riesgo en enfermedad renal crónica. Acta Med Colomb. 2013; 38(4): 204-5.
6. Tsai S-Y, Tseng H-F, Tan H-F, Chien Y-S, Chang C-C. End-stage renal disease in Taiwan: a case-control study. J Epidemiol. 2009; 19(4): 169-76.
7. Cheu C, Pearson J, Dahlerus C, Lantz B, Chowdhury T, Sauer PF, et al. Association between oral nutritional supplementation and clinical outcomes among patients with ESRD. Clin J Am Soc Nephrol. 2012; 8(1): 100-7.
8. Hernandez-Morante J, Sanchez-Villazala A, Cutillas R, Fuentes M. Effectiveness of a nutrition education program for the prevention and treatment of malnutrition in end-stage renal disease. J Ren Nutr. 2014; 24(1): 42-9.
9. Riobó P, Ortiz A. Nutrición en la insuficiencia renal. Nutri Info [Internet]. 2010. pp. 1-19. Available from: http:// www.fresenius-kabi.es/pdf/nutri_info/Nutri_Info_05.pdf
10. López MR, Cuadrado GB, Sellares VL. Guía de nutrición en enfermedad renal crónica avanzada (ERCA). Nefrología. 2008; 28(Suppl 3): 79-86.
11. Barril-Cuadrado G, Puchulu MB, Sánchez-Tomero JA. Table showing dietary phosphorus/protein ratio for the Spanish population. Usefulness in chronic kidney disease. Nefrología. 2013; 33(3): 362-71.
12. Kopple J. National Kidney Foundation K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2001; 37(1 Suppl 2): 66-70.
13. Langman CB, Cannata-Andía JB. Calcium in chronic kidney disease: myths and realities. Introduction. Clin J Am Soc Nephrol. 2010; 5 (Suppl 1): S1-2.
14. Blair D, Byham-Gray L, Lewis E, McCaffrey S. Prevalence of vitamin D [25(OH)D] deficiency and effects of supplementation with ergocalciferol (vitamin D2) in stage 5 chronic kidney disease patients. J Ren Nutr. 2008;18(4): 375-82.
15. Cronin SC. The dual vitamin D pathways: considerations for adequate supplementation. Nephrol Nurs J. 2010; 37(1): 19-26, 36; quiz 27-8.
16. Teplan V, Schück O, Knotek A, Hajný J, Horácková M, Skibová J, et al. Effects of low-protein diet supplemented with ketoacids and erythropoietin in chronic renal failure: a long-term metabolic study. Ann Transplant. 2001; 6(1): 47-53.
17. Ranganthan N, Friedman E, Tam P, Rao V, Ranganthan P, Dheer R. Probiotic dietary supplementation in patients with stage 3 and 4 chronic kidney disease: a 6-month pilot scale trial in Canada. Curr Med Res Opin. 2009; 25(8):1919-30.
18. Melamed ML, Thadhani RI. Vitamin D therapy in chronic kidney disease and end stage renal disease. Clin J Am Soc Nephrol. 2012; 7(2): 358-65.
19. Mann MC, Exner D V, Hemmelgarn BR, Hanley DA, Turin TC, Macrae JM, et al. The VITAH trial vitamin D supplementation and cardiac autonomic tone in hemodialysis: a blinded , randomized controlled trial. BMC Nephrol. 2014; 15(1): 1-9.
20. Daud Z, Tubie B, Sheyman M, Osia R, Adams J, Tubie S, et al. Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients. Vasc Health Risk Manag. 2013; 9(1): 747-61.
21. Khajehdehi P, Mojerlou M, Behzadi S, Rais-jalali GA. A randomized, double-blind, placebo-controlled trial of supplementary vitamins E, C and their combination for treatment of haemodialysis cramps. Nephrol Dial Transpl. 2001; (16): 1448-51.
22. Roozbeh J, Hedayati P, Sagheb MM, Sharifian M, Hamidian Jahromi A, Shaabani S, et al. Effect of zinc supplementation on triglyceride, cholesterol, LDL, and HDL levels in zinc-deficient hemodialysis patients. Inf Healthc. 2009; 31(9): 798-801.
23. Pakfetrat M, Shahroodi JR, Zolgadr AA, Larie HA, Nikoo MH, Malekmakan L. Effects of zinc supplement on plasma homocysteine level in end-stage renal disease patients: a double-blind randomized clinical trial. Biol Trace Elem Res. 2013; 153(1-3): 11-5.
24. Guo CH, Chen PC, Hsu GS, Wang CL. Zinc supplementation alters plasma aluminum and selenium status of patients undergoing dialysis: A pilot study. Nutrients. 2013; 5(4): 1456-70.
25. Rashidi A, Salehi M, Piroozmand A, Sagheb M. Effects of zinc supplementation on serum zinc and C-reactive protein concentrations in hemodialysis patients. J Ren Nutr. 2009; 19(6): 475-8.
26. Calvo MS, Uribarri J. Contributions to total phosphorus intake: all sources considered. Semin Dial. 2013; 26(1): 54-61.
27. Khosroshahi HT, Dehgan R, Asl BH, Safaian A, Panahi F, Estakhri R, et al. Effect of omega-3 supplementation on serum level of homocystein in hemodialysis patients. Iran J Kidney Dis. 2013; 7(6): 479-84.
28. Beavers KM, Beavers DP, Bowden RG, Wilson RL, Gentile M. Omega-3 fatty acid supplementation and total homocysteine levels in nd-stage renal disease patients. Nephrology (Carlton). 2008; 13(4): 284-8.
29. Tayyebi-Khosroshahi H, Houshyar J, Dehgan-Hesari R, Alikhah H. Effect of treatment with omega-3 fatty acids on C reactive protein and tumor necrosis factor-alfa in hemodialysis patients. Saudi J Kidney Dis Transplant. 2012; 38(May): 740-7.
30. Gharekhani A, Khatami M-R, Dashti-Khavidaki S. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo- ontrolled clinical trial. Eur J Clin Pharmacol. 2014; 70(6): 655-65.
31. Moretti H, Johnson AM, Keeling-Hathaway TJ. Effects of protein supplementation in chronic hemodialysis and peritoneal dialysis patients. J Ren Nutr. National Kidney Foundation, Inc. 2009; 19(4): 298-303.
32-. Aparicio M, Bellizzi V, Chauveau P, Cupisti A, Ecder T, Fouque D, et al. Protein-restricted diets plus keto/amino acids - a valid therapeutic approach for chronic kidney disease patients. J Ren Nutr. 2012; 22(Suppl 2): S1-21.
33. Sundell MB, Cavanaugh KL, Wu P, Shintani A, Hakim RM, Ikizler TA. Oral protein supplementation alone improves anabolism in a dose-dependent manner in chronic hemodialysis patients. J Ren Nutr. National Kidney Foundation, Inc. 2009; 19(5): 412-21.
34. Qin X, Huo Y, Xie D, Hou F, Xu X, Wang X. Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: a meta-analysis of randomized controlled trials. Clin Nutr. 2013; 32(5): 722-7.
35. Leung J. Folic acid supplementation and cardiac and stroke mortality among hemodialysis patients. J Ren Nutr. 2011; 20(5): 293-302.
36. Dierkes J, Domröse U, Bosselmann KP, Neumann KH, Luley C. omocysteine lowering effect of different multivitamin preparations in patients with end-stage renal disease. J Ren Nutr. 2001; 11(2): 67-72.
37. Cano N, Fiaccadori E, Tesinsky P, Toigo G, Druml W, Medicine D, et al. SPEN Guidelines on enteral nutrition: Adult renal failure. Clin Nutr. 2006; 25(2): 295-310.
38. Chevalier C. The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients. J Ren Nutr. 2002;10(3): 148-53.
2. Snyder J, Foley R, Collins A. Prevalence of CKD in the United States: a sensitivity analysis using the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Am J Kidney Dis. 2009; 53(2): 218-28.
3. Eknoyan G, Lameire N, Eckardt K-U, Kasiske B, Wheeler D, Willis K, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013; 3(1): 1-150.
4. Rosselli D, Tarazona N, Aroca A. La salud en Colombia 1953-2013: Un análisis de estadísticas vitales. Med. 2014; 36(2): 120-35.
5. Cantillo J, Madera AM. Importancia del control de los factores de riesgo en enfermedad renal crónica. Acta Med Colomb. 2013; 38(4): 204-5.
6. Tsai S-Y, Tseng H-F, Tan H-F, Chien Y-S, Chang C-C. End-stage renal disease in Taiwan: a case-control study. J Epidemiol. 2009; 19(4): 169-76.
7. Cheu C, Pearson J, Dahlerus C, Lantz B, Chowdhury T, Sauer PF, et al. Association between oral nutritional supplementation and clinical outcomes among patients with ESRD. Clin J Am Soc Nephrol. 2012; 8(1): 100-7.
8. Hernandez-Morante J, Sanchez-Villazala A, Cutillas R, Fuentes M. Effectiveness of a nutrition education program for the prevention and treatment of malnutrition in end-stage renal disease. J Ren Nutr. 2014; 24(1): 42-9.
9. Riobó P, Ortiz A. Nutrición en la insuficiencia renal. Nutri Info [Internet]. 2010. pp. 1-19. Available from: http:// www.fresenius-kabi.es/pdf/nutri_info/Nutri_Info_05.pdf
10. López MR, Cuadrado GB, Sellares VL. Guía de nutrición en enfermedad renal crónica avanzada (ERCA). Nefrología. 2008; 28(Suppl 3): 79-86.
11. Barril-Cuadrado G, Puchulu MB, Sánchez-Tomero JA. Table showing dietary phosphorus/protein ratio for the Spanish population. Usefulness in chronic kidney disease. Nefrología. 2013; 33(3): 362-71.
12. Kopple J. National Kidney Foundation K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2001; 37(1 Suppl 2): 66-70.
13. Langman CB, Cannata-Andía JB. Calcium in chronic kidney disease: myths and realities. Introduction. Clin J Am Soc Nephrol. 2010; 5 (Suppl 1): S1-2.
14. Blair D, Byham-Gray L, Lewis E, McCaffrey S. Prevalence of vitamin D [25(OH)D] deficiency and effects of supplementation with ergocalciferol (vitamin D2) in stage 5 chronic kidney disease patients. J Ren Nutr. 2008;18(4): 375-82.
15. Cronin SC. The dual vitamin D pathways: considerations for adequate supplementation. Nephrol Nurs J. 2010; 37(1): 19-26, 36; quiz 27-8.
16. Teplan V, Schück O, Knotek A, Hajný J, Horácková M, Skibová J, et al. Effects of low-protein diet supplemented with ketoacids and erythropoietin in chronic renal failure: a long-term metabolic study. Ann Transplant. 2001; 6(1): 47-53.
17. Ranganthan N, Friedman E, Tam P, Rao V, Ranganthan P, Dheer R. Probiotic dietary supplementation in patients with stage 3 and 4 chronic kidney disease: a 6-month pilot scale trial in Canada. Curr Med Res Opin. 2009; 25(8):1919-30.
18. Melamed ML, Thadhani RI. Vitamin D therapy in chronic kidney disease and end stage renal disease. Clin J Am Soc Nephrol. 2012; 7(2): 358-65.
19. Mann MC, Exner D V, Hemmelgarn BR, Hanley DA, Turin TC, Macrae JM, et al. The VITAH trial vitamin D supplementation and cardiac autonomic tone in hemodialysis: a blinded , randomized controlled trial. BMC Nephrol. 2014; 15(1): 1-9.
20. Daud Z, Tubie B, Sheyman M, Osia R, Adams J, Tubie S, et al. Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients. Vasc Health Risk Manag. 2013; 9(1): 747-61.
21. Khajehdehi P, Mojerlou M, Behzadi S, Rais-jalali GA. A randomized, double-blind, placebo-controlled trial of supplementary vitamins E, C and their combination for treatment of haemodialysis cramps. Nephrol Dial Transpl. 2001; (16): 1448-51.
22. Roozbeh J, Hedayati P, Sagheb MM, Sharifian M, Hamidian Jahromi A, Shaabani S, et al. Effect of zinc supplementation on triglyceride, cholesterol, LDL, and HDL levels in zinc-deficient hemodialysis patients. Inf Healthc. 2009; 31(9): 798-801.
23. Pakfetrat M, Shahroodi JR, Zolgadr AA, Larie HA, Nikoo MH, Malekmakan L. Effects of zinc supplement on plasma homocysteine level in end-stage renal disease patients: a double-blind randomized clinical trial. Biol Trace Elem Res. 2013; 153(1-3): 11-5.
24. Guo CH, Chen PC, Hsu GS, Wang CL. Zinc supplementation alters plasma aluminum and selenium status of patients undergoing dialysis: A pilot study. Nutrients. 2013; 5(4): 1456-70.
25. Rashidi A, Salehi M, Piroozmand A, Sagheb M. Effects of zinc supplementation on serum zinc and C-reactive protein concentrations in hemodialysis patients. J Ren Nutr. 2009; 19(6): 475-8.
26. Calvo MS, Uribarri J. Contributions to total phosphorus intake: all sources considered. Semin Dial. 2013; 26(1): 54-61.
27. Khosroshahi HT, Dehgan R, Asl BH, Safaian A, Panahi F, Estakhri R, et al. Effect of omega-3 supplementation on serum level of homocystein in hemodialysis patients. Iran J Kidney Dis. 2013; 7(6): 479-84.
28. Beavers KM, Beavers DP, Bowden RG, Wilson RL, Gentile M. Omega-3 fatty acid supplementation and total homocysteine levels in nd-stage renal disease patients. Nephrology (Carlton). 2008; 13(4): 284-8.
29. Tayyebi-Khosroshahi H, Houshyar J, Dehgan-Hesari R, Alikhah H. Effect of treatment with omega-3 fatty acids on C reactive protein and tumor necrosis factor-alfa in hemodialysis patients. Saudi J Kidney Dis Transplant. 2012; 38(May): 740-7.
30. Gharekhani A, Khatami M-R, Dashti-Khavidaki S. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo- ontrolled clinical trial. Eur J Clin Pharmacol. 2014; 70(6): 655-65.
31. Moretti H, Johnson AM, Keeling-Hathaway TJ. Effects of protein supplementation in chronic hemodialysis and peritoneal dialysis patients. J Ren Nutr. National Kidney Foundation, Inc. 2009; 19(4): 298-303.
32-. Aparicio M, Bellizzi V, Chauveau P, Cupisti A, Ecder T, Fouque D, et al. Protein-restricted diets plus keto/amino acids - a valid therapeutic approach for chronic kidney disease patients. J Ren Nutr. 2012; 22(Suppl 2): S1-21.
33. Sundell MB, Cavanaugh KL, Wu P, Shintani A, Hakim RM, Ikizler TA. Oral protein supplementation alone improves anabolism in a dose-dependent manner in chronic hemodialysis patients. J Ren Nutr. National Kidney Foundation, Inc. 2009; 19(5): 412-21.
34. Qin X, Huo Y, Xie D, Hou F, Xu X, Wang X. Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: a meta-analysis of randomized controlled trials. Clin Nutr. 2013; 32(5): 722-7.
35. Leung J. Folic acid supplementation and cardiac and stroke mortality among hemodialysis patients. J Ren Nutr. 2011; 20(5): 293-302.
36. Dierkes J, Domröse U, Bosselmann KP, Neumann KH, Luley C. omocysteine lowering effect of different multivitamin preparations in patients with end-stage renal disease. J Ren Nutr. 2001; 11(2): 67-72.
37. Cano N, Fiaccadori E, Tesinsky P, Toigo G, Druml W, Medicine D, et al. SPEN Guidelines on enteral nutrition: Adult renal failure. Clin Nutr. 2006; 25(2): 295-310.
38. Chevalier C. The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients. J Ren Nutr. 2002;10(3): 148-53.
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