2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T826,Protein-energy wasting, chronic inflammation, and functional decline are prevalent among patients undergoing haemodialysis (HD) and are associated with adverse outcomes and reduced quality of life. Although a substantial body of literature exists on nutritional management in HD, evidence has evolved considerably in recent years. Nutritional care in HD remains inconsistent and is limited by restrictive dietary paradigms and organizational barriers. To map evidence published between 2015 and 2025 on nutritional management in adult patients undergoing HD, focusing on personalized strategies, barriers to effective nutritional care, and patient-centred, function-oriented implementation. A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA Extension for Scoping Reviews. PubMed/MEDLINE, Scopus, Web of Science, and Europe PMC were searched for English-language studies published between January 2015 and August 2025. A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD. This scoping review highlights a shift towards more personalized and function-oriented nutritional care in HD, while underscoring persistent barriers and substantial evidence heterogeneity. The findings support future research and the development of more integrated, patient-centred, and sustainable nutritional care models.31:Tb3a,ABSTRACT Background Protein-energy wasting, chronic inflammation, and functional decline are prevalent among patients undergoing haemodialysis (HD) and are associated with adverse outcomes and reduced quality of life. Although a substantial body of literature exists on nutritional management in HD, evidence has evolved considerably in recent years. Nutritional care in HD remains inconsistent and is limited by restrictive dietary paradigms and organizational barriers. Objective To map evidence published between 2015 and 2025 on nutritional management in adult patients undergoing HD, focusing on personalized strategies, barriers to effective nutritional care, and patient-centred, function-oriented implementation. Methods A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA Extension for Scoping Reviews. PubMed/MEDLINE, Scopus, Web of Science, and Europe PMC were searched for English-language studies published between January 2015 and August 2025. Results A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD. Conclusions This scoping review highlights a shift towards more personalized and function-oriented nutritional care in HD, while underscoring persistent barriers and substantial evidence heterogeneity. The findings support future research and the development of more integrated, patient-centred, and sustainable nutritional care models. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Protein-Energy Wasting: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Protein-Energy Wasting (condition). Clinician-written summaries and actionable practice insights. 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Key thresholds include: screen all dialysis patients at least every 3 months; start ONS when spontaneous intake cannot meet needs after counseling (target ~250–300 kcal/day); initiate IDPN when oral + ONS intake still falls short but spontaneous intake exceeds 50% of requirements; prescribe IDPN for 3.5–4 hour sessions with a stepped volume increase. Fish oil supplementation (4 capsules/day) in the PISCES trial reduced serious cardiovascular events by ~40% (HR 0.57, 95% CI 0.47–0.70) in hemodialysis patients.","limitations":"- All statements are expert consensus, not derived from high-quality RCTs; most IDPN trials are small, heterogeneous, and lack standardized endpoints.\n- The entire expert group received honoraria and travel support from Fresenius Kabi, the manufacturer of IDPN products, creating a significant conflict of interest.\n- Guidance covers only ONS and IDPN; enteral nutrition and total PN are addressed only briefly.","practice_takeaway":"Screen every dialysis patient for protein-energy wasting at least quarterly using MIS or SGA, and escalate support stepwise: counseling → ONS → IDPN (or enteral nutrition) based on intake adequacy and PEW severity. When starting IDPN, use a gradual step-up infusion approach and monitor glucose, triglycerides, electrolytes, and volume status closely at each session, especially in the first two weeks."}},{"doi":"10.1093/ckj/sfag117","pmid":"42094027","title":"Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag117","source_score":42,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-19","doi":"10.1093/ckj/sfag117","days":"30","issn":"2048-8505","rank":"5","field":"Clinical Medicine","score":"42","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ckj/sfag117","title":"Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025.","journal":"Clinical kidney journal","methods":"","results":"A total of 30 studies were included. 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Supplementation","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"modality","value":"Plant-Based Diet","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"modality","value":"Probiotic / Prebiotic / Synbiotic","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"sample_size","value":"n=30 studies","value_numeric":30},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"study_design","value":"Scoping Review","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"warning","value":"Sample size tag reflects number of included studies (n=30), not individual patients — total patient numbers vary widely across studies and are not reported in aggregate.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"warning","value":"Several included studies are themselves systematic reviews or meta-analyses; the evidence hierarchy is therefore indirect for some conclusions.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag117","tag_type":"warning","value":"The scoping review design maps evidence but does not provide pooled effect estimates; impact flag 'limited_evidence' reflects the overall body of evidence reviewed, not a single trial.","value_numeric":null}],"summaries":{"what_studied":"A scoping review (JBI methodology, PRISMA-ScR) mapping evidence from 30 studies published January 2015–August 2025 on personalized nutritional strategies, barriers to care, and assessment tools in adult patients (≥18 years) undergoing maintenance haemodialysis (HD).","key_result":"Across 30 included studies (17 primary research, 13 reviews), dietary non-adherence affected ~60% of HD patients. Personalized oral/intradialytic supplementation, plant-forward diets, gut microbiota strategies, and targeted nutrients improved nutritional biomarkers and selected functional outcomes, but evidence was limited by small trials (<100 participants, 6–16 week follow-up) and high heterogeneity. Morphofunctional tools (muscle ultrasound, multifrequency BIA, MIS) outperformed serum albumin and BMI for detecting nutritional risk, especially in older adults. Only 36% of HD centres employed permanent renal dietitians, and <25% had standardized nutritional assessment protocols.","limitations":"- Most interventional studies were small and short-term, limiting generalizability and preventing firm recommendations.\n- Restriction to four databases and English-language publications may have missed relevant evidence.\n- Substantial methodological heterogeneity precluded meta-analysis; hard clinical endpoints (mortality, hospitalization) were rarely reported.","practice_takeaway":"Integrate renal dietitians and morphofunctional assessment (muscle ultrasound, BIA, MIS) into routine HD care rather than relying on albumin or BMI alone. Shift from rigid universal renal diets toward flexible, culturally adapted, patient-centred nutritional plans with structured psychosocial support to address the ~60% non-adherence rate."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Protein-Energy Wasting"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Protein-Energy Wasting"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Protein-Energy Wasting"}}}]]

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