Propuesta nutricional y dietoterapéutico basado en evidencia para el manejo integral de un paciente con Enfermedad Renal Etapa 5, con antecedente de hipertensión arterial.

Abstract

This clinical case comprehensively evaluates the nutritional status of a 28-year-old patient diagnosed with hypertension and stage 5 chronic kidney disease undergoing hemodialysis. To assess nutritional status, the ABCD methodology was used, which evaluates body composition, anthropometry, and grip strength using bioelectrical impedance analysis, skinfold calipers, a measuring tape, and a dynamometer. The results determined that the patient is in a state of protein-energy malnutrition, defined by a decreased lean body mass index (17.2 kg/m2) and an energy intake deficit of >70% of requirements. Therefore, the patient presents a high risk of malnutrition related to protein-energy wasting, inflammation, a catabolic state, and hyporexia. A nutritional management plan is proposed, based on a dietary pattern distributed across five meals, supplemented with nutritional supplements such as Vitamin D, B Complex, and Pentasure DLS. The diet consists of a high-calorie intake (35 kcal/kg/day) and a high-protein intake (1.4 g/kg/day), with monitored sodium, potassium, and phosphorus levels. To assess treatment adherence, it is recommended to monitor biochemical parameters, grip strength, and body composition. Both the initial prescription and any adjustments should be individualized to improve the patient's parameters and quality of life.