Comparative Study between Enteral andIntradialytic Parenteral Nutrition in Hemodialysis Patients

Abstract

Chronic kidney disease (CKD) is recognized as a major health problem. It describes abnormal kidney function and/or structure. It is common, frequently unrecognized and often exists together with other conditions (for example, cardiovascular disease and diabetes). When advanced, it also carries a higher risk of mortality. The risk of developing CKD increases with increasing age, and some conditions that coexist with CKD become more severe as kidney dysfunction advances. CKD can progress to established renal failure in a small but significant percentage of people. The progression of chronic kidney disease usually occurs in four stages: diminished renal reserve, renal insufficiency, renal failure, and end-stage renal disease. Diminished renal reserve occurs when the glomerular filtration rate (GFR) drops to approximately 50% of normal. Renal insufficiency represents a reduction in the GFR to 20% to 50% of normal. Renal failure develops when the GFR is less than 20% of normal. End-stage renal disease (ESRD) occurs when the GFR is less than 5% of normal. Dialysis or renal replacement therapy is indicated when advanced uremia or serious electrolyte imbalances are present. The choice between dialysis and transplantation is dictated by age, related health problems, donor availability, and personal preference. Serum creatinine levels of > 6 mg/dL in males (4 mg/dL in females) and a GFR < 4 mL/min are the laboratory thresholds that are often used to indicate the need for dialysis therapy. Although transplantation often is the treatment preference, dialysis plays a critical role as a treatment method for ESRD. It is life sustaining for persons who are not candidates for transplantation or who are awaiting transplantation. There are two broad categories of dialysis: hemodialysis and peritoneal dialysis.