P958 - CLINICAL CASE: MALNUTRITION IN CHRONIC KIDNEY DISEASE – A PERSONALIZED NUTRITIONAL APPROACH

P958

CLINICAL CASE: MALNUTRITION IN CHRONIC KIDNEY DISEASE – A PERSONALIZED NUTRITIONAL APPROACH

L. Bueno Mena-Bernal¹, N. Santos Collado¹, A. Cidoncha Murillo¹, F. J. Toro Prieto^1,*

¹Nefrologia, Hospital Virgen del Rocio, Sevilla, Spain

Rationale: Advanced CKD management requires proper nutrition to prevent protein-energy wasting (PEW), which worsens disease progression. PEW results from low intake, dietary restrictions, inflammation, and comorbidities like diabetes. Multidisciplinary care and effective nutrition strategies are essential to reduce risks.

Methods: A Crohn’s disease patient with a history of ileal resection and CKD from prolonged 5-aminosalicylic acid use was hospitalized for severe malnutrition, acute renal failure, and metabolic imbalances. Nutritional support started with hypoproteic supplements, transitioning to normoproteic upon discharge.

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Results: The patient, diagnosed with Crohn's disease in childhood, underwent ileal resection and hemicolectomy in 1972, resulting in short bowel syndrome. After being lost to follow-up until 2023, the patient continued treatment with mesalazine, short courses of steroids, and antidiarrheals. In 2015, the patient was diagnosed with chronic kidney disease (CKD G4A1), likely due to chronic tubulointerstitial nephropathy from prolonged use of 5-ASA. Hospitalized on November 16, 2023, with general deterioration, asthenia, and a weight loss of 20 kg, the patient presented with severe malnutrition (BMI 15.6, weight loss of 28.5%), muscle atrophy, and no signs of fluid overload. Initial treatment included low-protein supplements, transitioning to normoproteic hypercaloric supplements upon discharge. Follow-up at 3 and 6 months showed weight gain, improved nutritional status, reduced fluid overload, increased fat mass, and stable progression of CKD. Tables 1-2.

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Conclusion: This case highlights the importance of personalized nutrition in ACKD. Normoproteic supplements improved nutrition without worsening renal function, supporting individualized approaches for PEW management. Early detection, multidisciplinary care, and tailored nutrition are key to better outcomes in high-risk CKD patients.

Disclosure of Interest: None declared