Eiwitbeperkt dieet bij geriatrische CNI-patiënten: de opinie van geriaters en nefrologen

Low protein diet in geriatric CKD-patients and sarcopenia: current opinion among geriatricians and nephrologists Introduction: One of the possible strategies to slow the progression of chronic kidney disease (CKD) is a low protein diet (LPD). Protein supplementation is on the other hand indicated to prevent sarcopenia, a common comorbidity in CKD. The current geriatric guidelines suggest a higher protein intake in geriatric patients with CKD stage 3-5 than nephrology guidelines. The effects of a LPD on sarcopenia are unclear. This study explores the willingness to prescribe a LPD and the opinion about protein intake in this population among nephrologists and geriatricians. Method: A survey was conducted among geriatricians and nephrologists in Antwerp. Prescribing behavior was compared between them and again after raising awareness about the subject. Results: 32 geriatricians and 28 nephrologists were included. Among geriatricians 55.6% were not willing and 33.3% rather not willing to prescribe a LPD. Among nephrologists, this was 57.7% and 42.3%, respectively (p=0.506). Raising awareness only resulted in a significant decrease in the number of geriatricians who were concerned about sarcopenia (60.0% versus 86.2%, p<0.001). Otherwise, no significant differences were seen within and between specialties. Kidney function is not taken into account when prescribing protein supplements by geriatricians. Discussion and conclusion: Both geriatricians and nephrologists seem equally reluctant to prescribe a LPD in geriatric patients with CKD stage 3-5. Consensus on the optimal protein intake is reached and seems to fall between their guidelines.