Feeding disorder in chronic kidney disease: case report

Abstract

Introduction: Pica in patients with chronic kidney disease is a poorly studied eating disorder and reported in the scientific publications, however, it is known to be common in this population and with unknown prevalence. Pica is defined as compulsive ingestion by non-nutritive substances and its etiology is assumed to be related to social, cultural, psychological, biological and behavioral factors. Case description: This was a descriptive case-report study with nutritional and psychological approach of a 32-year-old patient with chronic kidney disease undergoing peritoneal dialysis for ten years. Based on nutritional assessment, the patient presented with clinical signs of malnutrition, monotonous diet and poor adherence to dietary guidelines. The psychological aspects associated with renal treatment were depression, anxiety with symptoms of depersonalization of body image and history of severe psychological abuse. Discussion: Although the specific causes are unknown, it is suggested from a nutritional point of view that micronutrient deficiency such as iron and zinc favors the occurrence of pica. This disorder can lead to complications such as changes in electrolytes, malabsorption of other nutrients and malnutrition. To cope with psychic symptoms, the pica is used as a relief for emotional distress. Conclusion: Eating disorders are common in renal patients and the multiprofessional approach with preventive proposals and promoters of resilient strategies and support are fundamental in treatment.