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      Nueva herramienta de cribado nutricional para pacientes hospitalizados con enfermedad renal crónica: traducción, adaptación transcultural del iNUT Renal al castellano y comparación con cuestionarios clásicos Translated title: New nutritional screening tool for hospitalized patients with chronic kidney disease: translation, cross-cultural adaptation of Renal iNUT into Spanish and comparison with classic questionnaires

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          Abstract

          Resumen Introducción: la enfermedad renal crónica (ERC) se caracteriza por su alta prevalencia de malnutrición, de difícil detección al ser subestimada por las herramientas habitualmente usadas. No existe un cribado nutricional válido a nivel hospitalario en castellano para identificar pacientes con ERC en riesgo de malnutrición. Objetivo: traducir y realizar la adaptación transcultural al castellano del cuestionario de Jackson y cols. (Renal Inpatient Nutrition Screening Tool [iNUT Renal]), que detecta el riesgo de malnutrición en pacientes con ERC ingresados, y compararlo con herramientas nutricionales clásicas. Métodos: fase 1: traducción, retrotraducción y adaptación transcultural del cuestionario en versión inglesa a la versión castellana. Prueba piloto realizada por enfermería con posterior cuestionario de satisfacción. Fase 2: comparación de iNUT Renal con Malnutrition Universal Screening Tool (MUST) y Valoración Global Subjetiva (VGS). Resultados: fase 1: la valoración de enfermería fue altamente favorable. Lo consideraron fácil o muy fácil de utilizar y el 90 % lo realizó en un máximo de diez minutos. Fase 2: de los 48 pacientes incluidos, iNUT Renal detectó un 44 % en riesgo bajo de malnutrición, 28 % en riesgo intermedio y 28 % en riesgo alto. Se halló mayor sensibilidad del iNUT Renal (p < 0,007) vs. MUST (62,5 vs. 33,3 %), similar especificidad (87,1 vs. 90,6 %) y aceptable correlación en comparación con VGS (r = 0,75, IC 95 %: 0,67-0,83). Conclusiones: la versión castellana de iNUT Renal es una herramienta útil y de fácil comprensión para el personal sanitario. Asimismo, confirmamos su buena correlación con VGS, con mayor sensibilidad que MUST para la detección del riesgo de malnutrición en el paciente con ERC ingresado.

          Translated abstract

          Abstract Introduction: chronic kidney disease (CKD) is characterized by its high prevalence of malnutrition, difficult to detect as it is underestimated by the usual tools. There is no valid or hospital-level nutritional screening tool in Spanish to identify patients with CKD at risk of malnutrition. Objective: to translate and accomplish the transcultural adaptation of Jackson‘s questionnaire (Renal Inpatient Nutrition Screening Tool [Renal iNUT]) to Spanish, which detects the risk of malnutrition in CKD inpatients and compares it with other nutritional tools. Methods: phase 1: translation, back-translation and transcultural adaptation of the questionnaire from the English to the Spanish version. A pilot test was carried out by nursing staff together with a satisfaction questionnaire. Phase 2: comparison of Renal iNUT with Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA). Results: phase 1: the nursing staff's perception was highly favorable. They found it easy or very easy to use and 90 % of them did it in a maximum of ten minutes. Phase 2: from 48 patients included, Renal iNUT detected 44 % at low risk of malnutrition, 28 % at intermediate risk and 28 % at high risk. Increased sensitivity of Renal iNUT (p < 0.007) vs MUST (62.5 vs 33.3 %) and similar specificity (87.1 vs 90.6 %) were found, together with an acceptable correlation compared to SGA (r = 0.75, 95 % CI: 0.67 to 0.83). Conclusions: the Spanish version of Renal iNUT is a useful and easy-to-understand tool for health professionals. We also confirm its good correlation with SGA, with greater sensitivity than MUST for the risk of malnutrition detection in CKD inpatients.

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          KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update

          The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for nutrition in kidney diseases since 1999. Since the publication of the first KDOQI nutrition guideline, there has been a great accumulation of new evidence regarding the management of nutritional aspects of kidney disease and sophistication in the guidelines process. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD was developed as a joint effort with the Academy of Nutrition and Dietetics (Academy). It provides comprehensive up-to-date information on the understanding and care of patients with chronic kidney disease (CKD), especially in terms of their metabolic and nutritional milieu for the practicing clinician and allied health care workers. The guideline was expanded to include not only patients with end-stage kidney disease or advanced CKD, but also patients with stages 1-5 CKD who are not receiving dialysis and patients with a functional kidney transplant. The updated guideline statements focus on 6 primary areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines primarily cover dietary management rather than all possible nutritional interventions. The evidence data and guideline statements were evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.
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            Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM).

            Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW. Published by Elsevier Inc.
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              Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism

              To better define the prevalence of protein-energy wasting (PEW) in kidney disease is poorly defined.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                December 2023
                : 40
                : 6
                : 1192-1198
                Affiliations
                [2] Barcelona orgnameHospital Clínic de Barcelona orgdiv1Servicio de Nefrología y Trasplante Renal Spain
                [3] Barcelona orgnameHospital Clínic de Barcelona orgdiv1Servicio de Endocrinología y Nutrición Spain
                [1] Barcelona orgnameHospital Clínic de Barcelona orgdiv1Servicio de Endocrinología y Nutrición Spain
                Article
                S0212-16112023000800011 S0212-1611(23)04000600011
                10.20960/nh.04538
                08070dd3-bde3-4df3-9653-05f1237c4308

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 18 November 2022
                : 22 June 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 7
                Product

                SciELO Spain

                Categories
                Trabajos Originales

                Cribado nutricional,Paciente hospitalizado,Traducción,Enfermedad renal crónica,Malnutrición,Inpatient,Translation,Nutritional screening,Chronic kidney disease,Malnutrition

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