1
|
Bogacka A, Sobczak-Czynsz A, Balejko E, Heberlej A, Ciechanowski K. Effect of Diet and Supplementation on Serum Vitamin C Concentration and Antioxidant Activity in Dialysis Patients. Nutrients 2022; 15:nu15010078. [PMID: 36615736 PMCID: PMC9824265 DOI: 10.3390/nu15010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Loss of vitamin C, especially in conjunction with an inadequate supply, can lead to decreased plasma concentrations of vitamin C. This in turn can lead to overt or subclinical deficiency. The present study aimed to evaluate the effects of diet and supplementation on vitamin C concentrations and serum antioxidant activity (FRAP) in hemodialysis (HD) patients. Sixty-eight HD patients participated in the study. In all of them, the diet was initially determined, and they were divided into five groups according to the diet and supplementation used. Group 1 received an unchanged diet, considered by them to be optimal; in group 2, the standard diet used in HD patients was introduced; in group 3, a standard diet enriched with natural antioxidants was employed; in group 4, a standard diet as in group 2 was used, but enriched with supplements (vitamin C, vitamin E, Se, and Zn). In contrast, group 5 consisted of HD patients with coexisting diabetes. Vitamin C serum levels were determined by high-performance liquid chromatography HPLC and antioxidant activity by The Ferric Reducing Ability of Plasma FRAP. The study shows that a well-chosen diet can slow the build-up of malnutrition and increase antioxidant activity as measured by the FRAP method in the blood of hemodialysis patients. Vitamin C supplementation can improve antioxidant status in hemodialysis patients. * The results presented in this paper complement our study, which assessed the effect of diet on the activity of erythrocyte antioxidant enzymes: Catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px), but also on the concentrations of non-enzymatic antioxidants (tocopherols, carotenoids, and vitamin C) in hemodialysis patients. In the study, plasma malondialdehyde (MDA) concentrations were assessed as an indicator of oxidative damage.
Collapse
Affiliation(s)
- Anna Bogacka
- Department of Commodity Quality Assessment Process Engineering and Human Nutrition, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, 71459 Szczecin, Poland
- Correspondence:
| | - Anna Sobczak-Czynsz
- Department of Commodity Quality Assessment Process Engineering and Human Nutrition, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, 71459 Szczecin, Poland
| | - Edyta Balejko
- Department of Commodity Quality Assessment Process Engineering and Human Nutrition, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, 71459 Szczecin, Poland
| | - Angelika Heberlej
- Department of Commodity Quality Assessment Process Engineering and Human Nutrition, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, 71459 Szczecin, Poland
| | - Kazimierz Ciechanowski
- Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, 70111 Szczecin, Poland
| |
Collapse
|
2
|
Gong Z, Chen T. Nutritional potassium limitation impact on serum potassium change, and death in chronic kidney disease: A meta-analysis. Ther Apher Dial 2022; 26:1079-1085. [PMID: 35247229 DOI: 10.1111/1744-9987.13831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We performed a meta-analysis to evaluate the impact of nutritional potassium limitation on serum potassium change, and death in chronic kidney disease. METHODS A systematic literature search up to October 2021 was done and 8 studies included 92 558 subjects with chronic kidney disease at the start of the study; 41 474 of them were provided with nutritional potassium limitation and 510 084 were nonrestricted diet. RESULTS Nutritional potassium limitation had significantly lower serum potassium change (MD, -0.33; 95% CI, -0.58- -0.07, p = 0.01) compared to nonrestricted diet in subjects with chronic kidney disease. However, nutritional potassium limitation had no significant impact on the death (OR, 0.80; 95% CI, 0.58-1.10, p = 0.17) compared to nonrestricted diet in subjects with chronic kidney disease. CONCLUSIONS Nutritional potassium limitation had significantly lower serum potassium change compared to nonrestricted diet in subjects with chronic kidney disease. Further studies are required to validate these findings. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Zhumei Gong
- Department of Emergency, Yiwu Central Hospital, Zhejiang, China
| | - Taiai Chen
- Department of Nephrology, Qionghai People's Hospital, Hainan, China
| |
Collapse
|
3
|
Morris A, Krishnan N, Kimani PK, Lycett D. CORRECTED ARTICLE: Effect of Dietary Potassium Restriction on Serum Potassium, Disease Progression, and Mortality in Chronic Kidney Disease: A Systematic Review and Meta-Analysis. J Ren Nutr 2022; 32:e1-e10. [PMID: 34980365 DOI: 10.1053/j.jrn.2021.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Low-potassium diets are recommended to reduce serum potassium (Sk) and prevent complications of chronic kidney disease (CKD), but evidence underpinning this recommendation has not been systematically reviewed and synthesized. We conducted a systematic review comparing change in Sk, CKD progression, and mortality between those on a low-potassium versus unrestricted potassium diet. METHODS We searched Medline, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, and Clinicaltrials.org from inception to 3 April 2018. We included randomized and observational studies that compared these outcomes in adults with CKD who ate a restricted versus unrestricted amount of dietary potassium. We pooled mean change in Sk and adjusted hazard ratios of disease progression and mortality using random-effects meta-analyses. RESULTS We identified 5,563 articles, of which seven studies (3,489 participants) met our inclusion criteria. We found very low-quality evidence that restricted (1,295 mg/d) versus unrestricted (1,570 mg/d) dietary potassium lowered Sk by -0.22 mEq/L (95% confidence interval [CI]: -0.33, -0.10; I2 = 0%). Higher (4,558 mg/d) versus lower (1,725 mg/d) dietary potassium was not significantly associated with disease progression (hazard ratio [HR]: 1.14, 95% CI: [0.77, 1.70] I² = 57%). Higher (4,414 mg/d) compared with lower (1,670 mg/d) dietary potassium intake was not significantly associated with reduced mortality risk (HR: 0.80, 95% CI: [0.46, 1.41] I² = 78%). CONCLUSIONS Very-low-quality evidence supports consensus that dietary potassium restriction reduces Sk in normokalemia but whether this is associated with risk of death in those with CKD is uncertain. High-quality randomized controlled trials are needed.
Collapse
Affiliation(s)
- Andrew Morris
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK; Renal Department, University Hospital, Coventry, UK.
| | | | - Peter K Kimani
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Deborah Lycett
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| |
Collapse
|
4
|
Al-Shibly K, Al-Diwan J. Effect of the dietary protein intake on urea reduction rate in patients on maintenance hemodialysis in Merjan Teaching Hospital. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
5
|
Kitabayashi K, Yamamoto S, Narita I. Magnesium intake by enteral formulation affects serum magnesium concentration in patients undergoing hemodialysis. Ther Apher Dial 2021; 26:749-755. [PMID: 34792294 DOI: 10.1111/1744-9987.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
Decreased serum magnesium levels are associated with mortality and fractures in patients with chronic kidney disease; however, there is no recommendation for Mg intake in these populations. This study used cross-sectional analysis to examine the association between Mg intake and serum Mg levels in patients undergoing hemodialysis. Sixty-one patients were included. The daily Mg intake was 185 mg (IQR: 151-203 mg), and serum Mg level was 2.4 mg/dL (IQR: 2.2-2.7 mg/dL). Multiple regression analysis showed that intake of enteral formulation by tube feeding was an independent factor associated with serum Mg level (B = 0.90 [95% confidence interval: 0.61-1.20], p < 0.01). These findings may aid in serum Mg level management through diet and enteral formulation in patients undergoing hemodialysis.
Collapse
Affiliation(s)
- Kou Kitabayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Nutrition, Shinkohkai Murakami-Kinen Hospital, Niigata, Japan
| | - Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
6
|
ALATAŞ H, YILDIRAN H, YALÇIN A. Hemodiyaliz tedavisi alan hastalarda besin alımı ile malnütrisyon inflamasyon skoru arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.794910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
7
|
Association between Serum Uric Acid Levels, Nutritional and Antioxidant Status in Patients on Hemodialysis. Nutrients 2020; 12:nu12092600. [PMID: 32867018 PMCID: PMC7551179 DOI: 10.3390/nu12092600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose: To determine the relationship between uric acid (UA) and nutritional and antioxidant status in hemodialysis (HD) patients, given that hyperuricemia could be an indicator of good nutritional status possibly because of the antioxidant properties of UA. Methods: Cross-sectional study with 93 patients on HD. Hyperuricemia was considered as UA ≥6.0 mg/dL in females and ≥7.0 mg/dL in males. Nutritional variables were registered. Blood samples were taken before the dialysis session to determine oxidative damage as plasma malondialdehyde (MDA) content, and antioxidant capacity measuring 2,2-diphenyl-piclrylhidrazil radical (DPPH●) scavenging activity and oxygen radical absorbance capacity (ORAC) value. Results: Patients with hyperuricemia had higher creatinine (11.9 vs. 10.5 mg/dL; p = 0.004), potassium (5.5 vs. 5.0 mg/dL; p = 0.014) levels; phase angle (5.8 vs. 4.9; p = 0.005), protein consumption (normalized protein nitrogen appearance, nPNA, 1.03 vs. 0.83; p = 0.013) than normouricemic patients. DPPH● scavenging activity was higher in hyperuricemic subjects (1.139 vs. 1.049 mM Trolox equivalents; p = 0.007); likewise, hyperuricemic subjects had less oxidant damage measured by MDA (10.6 vs. 12.7 nmol/mL; p = 0.020). Subjects with normouricemia were at higher risk of having a reactance to height (Xc/H) ratio less than 35 (OR 2.79; 95% CI, 1.1–7.017, p = 0.028); nPNA < 1.0 (OR 3.78; 95% CI, 1.4–10.2, p = 0.007), diagnosis of cachexia (OR 2.95; 95% CI, 1156–7.518, p = 0.021), potassium levels <5 (OR 2.97; 95% CI, 1.136–7.772, p = 0.023) and PA < 5.5° (OR 3.38; 95% CI, 1.309–8.749, p = 0.012.) Conclusions: Patients with hyperuricemia had higher antioxidant capacity and better nutritional status. Purines and protein restrictions in HD patients with hyperuricemia need to be reviewed individually for each patient. More studies are needed to stablish a cut point of UA levels in renal population.
Collapse
|
8
|
Morris A, Krishnan N, Kimani PK, Lycett D. Effect of Dietary Potassium Restriction on Serum Potassium, Disease Progression, and Mortality in Chronic Kidney Disease: A Systematic Review and Meta-Analysis. J Ren Nutr 2020; 30:276-285. [DOI: 10.1053/j.jrn.2019.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/23/2019] [Accepted: 09/15/2019] [Indexed: 12/27/2022] Open
|
9
|
Abstract
Objective:To evaluate the intake of energy and nutrients by individuals on hemodialysis, following especific recommendations for this population and according to Food Guide for the Brazilian Population.Methods: A cross-sectional study, 118 adult patients, considered stable from, ten dialysis centers in Goiânia, Goiás. Dietary intake was estimated by six 24-hour recalls, and classified as adequate or inadequate, according to specific recommendations for individuals undergoing dialysis and that recommended for a healthy diet. A descriptive analysis was performed.Results: Average dietary intake of 2022.40 ± 283.70 kcal/day; 31.18 kcal/kg/day; 55.03 ± 4.20% carbohydrate; 30.23 ± 3.71% lipid, 1.18 ± 0.23 g protein/kg/day. Important prevalences of inadequacy were observed for the intake of calories (39.0%), protein (39.0%) and other nutrients such as retinol (94.9%), saturated fat (87.3%), cholesterol (61,9%), iron (61.0%), potassium (60.2%) and zinc (45.0%). Patients had a low intake of fruit food group (1.22 ± 0.89 servings) and vegetables (1.76 ± 1.01 servings), dairy products (0.57 ± 0.43 servings) and high intake of food group of oils and fats (3.45 ± 0.95 servings), sugars and sweets (1.55 ± 0.77 servings).Conclusion: Observed food consumption imbalance, characterized by excess of oils and fats, especially saturated oils and cholesterol, sugars and sweets, parallel to low intake of fruits and vegetables and dairy products. A considerable percentage of patients did not intake the minimum recommended of calories, protein, retinol, iron, zinc and potassium.
Collapse
|
10
|
Cho JH, Hwang JY, Lee SE, Jang SP, Kim WY. Nutritional status and the role of diabetes mellitus in hemodialysis patients. Nutr Res Pract 2008; 2:301-7. [PMID: 20016734 PMCID: PMC2788193 DOI: 10.4162/nrp.2008.2.4.301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 11/19/2008] [Accepted: 11/25/2008] [Indexed: 11/25/2022] Open
Abstract
This study was aimed to investigate the nutritional status and the role of diabetes mellitus in hemodialysis (HD) patients. Anthropometric, biochemical, and dietary assessments for HD 110 patients (46 males and 64 females) were conducted. Mean body mass index (BMI) was 22.1 kg/m(2) and prevalence of underweight (BMI<18.5 kg/m(2)) was 12%. The hypoalbuminemia (<3.5 g/dl) was found in 15.5% of the subject, and hypocholesterolemia (<150 mg/dl) in 46.4%. About half (50.9%) patients had anemia (hemoglobin: <11.0 g/dL). High prevalence of hyperphosphatemia (66.4%) and hyperkalemia (43.5%) was also observed. More than 60 percent of subjects were below the recommended intake levels of energy (30-35 kcal/kg IBW) and protein (1.2 g/kg IBW). The proportions of subjects taking less than estimated average requirements for calcium, vitamin B(1), vitamin B(2), vitamin C, and folate were more than 50%, whereas, about 20% of the subjects were above the recommended intake of phosphorus and potassium. Diabetes mellitus was the main cause of ESRD (45.5%). The diabetic ESRD patients showed higher BMI and less HD adequacy than nondiabetic patients. Diabetic patients also showed lower HDL-cholesterol levels. Diabetic ESRD patients had less energy from fat and a greater percentage of calories from carbohydrates. In conclusion, active nutrition monitoring is needed to improve the nutritional status of HD patients. A follow-up study is needed to document a causal relation between diabetes and its impact on morbidity and mortality in ESRD patients.
Collapse
Affiliation(s)
- Ju-Hyun Cho
- Department of Nutritional Science and Food Management, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea
| | - Ji-Yun Hwang
- Department of Nutritional Science and Food Management, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea
| | - Sang-Eun Lee
- Department of Nutritional Science and Food Management, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea
| | - Sang Pil Jang
- Poog Sung Hemodialysis Clinic Center, 392-2, Pungnap 2-dong, Songpa-gu, Seoul 138-040, Korea
| | - Wha-Young Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Korea
| |
Collapse
|