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• W4242870903 abstract "This review discusses the diagnostic value of urinary parameters in the setting of advanced chronic kidney disease and we present the key concepts that summarize the suggestions of the manuscript. The amount of fluid intake may be a non-established risk factor for CKD. For these patients, a urinary output ≥2–3 l/day is a reasonable proposal. This recommendation is not applicable to patients with cardiorenal syndrome or fluid overload risk. This determination is very useful to monitor salt intake. Reducing urinary Na < 120 mEquiv./day (≅salt intake ≤ 5–6 g) is a reasonable objective. This parameter is useful to estimate protein intake (Maroni BJ equation). A protein intake between 48–72 g (0.8–0.9 g/kg/day according to weight) is equivalent to UUN 7–10 g/day approximately. Acid load reduction may be an additional strategy in the nutritional management of this population. It may be estimated indirectly from a diet survey or by measuring the elimination of UUN and Kur. The limits of this recommendation have not been established, but we propose a cautious and prudent diet of fruit and vegetables. There is a significant positive correlation between phosphorus and protein, both in dietary records and urine elimination. Based on this information, we suggest a urinary P excretion < 800 mg/day or < 600 mg/day for patients with GFR < 25 ml/min or <15 ml/min, respectively. Urinary parameters provide sensitive and useful knowledge for clinical practice, provide information about the dietary habits of patients and the adherence to our recommendations. En esta revisión discutimos el valor diagnóstico de los parámetros urinarios en la enfermedad renal crónica avanzada y exponemos los conceptos clave que resumen las sugerencias del manuscrito. La cantidad de líquido ingerida puede ser un factor de riesgo de enfermedad renal crónica no establecido. Alcanzar una diuresis ≥ 2-3 l al día es una propuesta razonable, no aplicable al síndrome cardiorrenal y riesgo de retención hidrosalina. determinación útil para vigilar la ingesta salina. Reducir la natriuresis < 120 mEq/d (≅ingesta sal ≤ 5-6 g) es un objetivo razonable. Útil para estimar la ingesta proteica (ecuación de Maroni). Una ingesta proteica entre 48-72 g (0,8-0,9 g/kg/día según peso) ≅NUU 7-10 g/día aproximadamente. La reducción de la carga ácida puede ser una estrategia adicional en el manejo nutricional de esta población. Puede estimarse de forma indirecta desde la encuesta dietética o midiendo la eliminación de NUU y Kur. Los límites en la recomendación no están establecidos; proponemos una liberación prudente de verduras y frutas. Existe estrecha asociación entre proteínas y fósforo, tanto en registro dietético como eliminación urinaria. El análisis combinado sugiere que para pacientes con FG < 25 mil/min, una fosfaturia < 800 mg/día, y con FG < 15 mil/min, una fosfaturia < 600 mg son objetivos razonables. Los parámetros urinarios proporcionan conocimiento sensible y de utilidad para la práctica clínica; aportan información de los hábitos dietéticos del paciente y de la adherencia a nuestras recomendaciones." @default.
• W4242870903 created "2022-05-12" @default.
• W4242870903 creator A5077835020 @default.
• W4242870903 date "2019-03-01" @default.
• W4242870903 modified "2023-10-18" @default.
• W4242870903 title "Usefulness of urinary parameters in advanced chronic kidney disease" @default.
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• W4242870903 doi "https://doi.org/10.1016/j.nefroe.2019.03.002" @default.
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