ABSTRACT
The nutritional situation of patients with end-stage renal disease (ESRD) is very heterogeneous. There is no uniform “kidney diet” as the demand for nutrients and ¬uid varies greatly, depending on age (infants, children, adolescents, adults), current body composition, mode of dialysis, underlying disease, concomitant diseases, and residual diuresis. Many patients show an imbalance of energy homeostasis, characterized by increased energy consumption and a concomitant lack of appetite because of a uremia-induced, disturbed appetite regulation. Acute life-threatening conditions may occur in case of excessive hyperhydration and hyperkalemia. The most important aims of nutritional modišcations are prevention of hyperhydration and cachexia, but nowadays also adiposity, electrolyte disorders, disturbed bone metabolism, and cardiovascular complications. In pediatric patients, it is most important to achieve adequate growth and development. Guidelines on nutrition in renal failure, which are based on the best information available at the time of publication, are available from the National Kidney Foundation of the USA (NKF-KDOQI 2000, 2003, 2007, 2009) and the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA 2009).
