Propuesta de abordaje nutricional y dietoterapéutico basado en evidencia para el manejo integral de un paciente con insuficiencia renal crónica y VIH: análisis retrospectivo de un caso clínico.

Abstract

This clinical case successfully met its objectives by comprehensively assessing the nutritional status of a 59-year-old patient with stage 5 chronic kidney disease on hemodialysis and HIV comorbidity. Using the ABCD methodology, bioelectrical impedance, and dynamometry, moderate protein-energy wasting was identified, characterized by reduced lean mass, a low lean tissue index (16 kg/m²), decreased handgrip strength (23.2 kg), and energy intake covering only 56% of requirements. This revealed a high nutritional risk linked to protein-energy wasting, chronic inflammation from HIV, and the catabolic state of hemodialysis; in response, an individualized nutritional intervention was designed, consisting of a hypercaloric and hyperproteic diet (35 kcal/kg and 1.4 g protein/kg of dry weight), with controlled potassium, phosphorus, and sodium intake, distributed across five to six daily meals and including one daily sachet of Pentasure DLS, continuous monitoring through periodic reassessment of anthropometric, biochemical, and adherence parameters was also recommended to adjust the strategy according to the patient’s progress, the case demonstrates that in patients with advanced chronic kidney disease and complex comorbidities, nutritional management must be highly individualized, comprehensive, and sustained over time to improve clinical prognosis and quality of life.