Abordaje clínico-nutricional en un adolescente con enfermedad renal crónica estadio 5 en hemodiálisis: reporte de caso.

Abstract

This study analyzes the clinical case of a 17-year-old adolescent with stage 5D chronic kidney disease (CKD) secondary to a congenital urinary tract malformation, currently undergoing hemodialysis. A descriptive, retrospective case study was conducted based on a review of records from July 2025 to May 2026. The assessment integrated medical history, clinical course, anthropometric data, clinical findings, dietary intake, biochemical parameters, and pharmacological treatment; data were organized using the SOAP method, and the nutritional diagnosis was established using the PES method. Findings included a BMI of 16.5 kg/m²—associated with intradialytic hypotension, malnutrition, muscle mass loss, and insufficient protein-energy intake—and a serum phosphorus level of 6.7 mg/dL. These findings indicate a high risk of nutritional loss and protein-energy wasting, although confirmation requires additional pediatric and functional indicators. Based on this, a nutritional intervention plan was developed featuring an energy intake of 35 kcal/kg/day and a protein intake of 1.1–1.2 g/kg/day; individual allowances for sodium, potassium, phosphorus, and fluids were adjusted through family education and nutritional-biochemical monitoring. This case demonstrates a nutritional management approach tailored to the specific needs of an adolescent with stage 5D CKD. The goal is to restore lost weight and muscle mass through an intervention focused on the individual's clinical progress, avoiding indiscriminate dietary restrictions, nutritional imbalances, poor dietary quality, and insufficient caloric intake.