The advanced chronic kidney disease is defined as a severe decrease in glomerular filtration rate (GFR) below 30 ml/min/1.73 m2, and includes stages 3B, 4 and 5.², e incluye los estadios 3B, 4 y 5.

The concept of malnutrition in CKD goes beyond a decrease in intake and weight loss, it encompasses a process of chronic inflammation, protein catabolism, metabolic changes and an accumulation of uremic toxins. Hence its specific definition as “Protein Energy Wasting” or its acronym PEW.

PEW predisposes to a worse prognosis and can lead to increased morbidity and mortality if intervention is not done in time. Its prevalence reaches up to 65% of patients on dialysis and in pre-dialysis stages, up to 28%.