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Jaber MM, Abdalla MA, Mizher A, Hammoudi H, Hamed F, Sholi A, AbuTaha A, Hassan M, Taha S, Koni AA, Shakhshir M, Zyoud SH. Prevalence and factors associated with the correlation between malnutrition and pain in hemodialysis patients. Sci Rep 2024; 14:14851. [PMID: 38937541 PMCID: PMC11211339 DOI: 10.1038/s41598-024-65603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024] Open
Abstract
Malnutrition and pain are common in patients with chronic kidney disease who undergo hemodialysis. Although both pain and malnutrition are associated with increased morbidity and mortality, few studies have explored the correlation between pain and nutritional status. This study aimed to investigate the factors associated with pain intensity in patients undergoing hemodialysis, focusing on the risk of malnutrition. This was a cross-sectional study conducted at a regional dialysis center in a large tertiary hospital. Convenience sampling was used to recruit adult patients who had undergone hemodialysis for more than three months. An interviewer-administered questionnaire was used to gather sociodemographic and clinical data related to dialysis status, comorbidities, and body mass index (BMI). Pain severity and pain interference with functioning domains of the Brief Pain Index (BPI) were used to assess pain, and the malnutrition inflammation score (MIS) was used to assess nutritional status. Descriptive and inferential statistics were used to report the findings. The data were analyzed using the 25th version of the Statistical Package for the Social Sciences (IBM-SPSS) software. Of the final sample of 230 patients, 63.0% were males and 37.0% were females, with an average age of 58.3 years. Almost one-third of the participants had a BMI within the normal range (33.9%), and nearly one-third had a BMI within the underweight range (33.9%). Slightly more than half had a normal nutritional status or mild malnutrition (54.8%), while just under half had moderate or severe malnutrition (45.2%). The prevalence of pain was 47.0%. At the multivariate level, the severity of pain was associated with malnutrition (p < 0.001). Pain interference with function was associated with marital status (p = 0.045), number of comorbidities (p = 0.012), and malnutrition (p < 0.001). The MIS was positively correlated with both the severity of pain and the interference score. Pain and malnutrition were found to be prevalent in patients undergoing hemodialysis. Pain severity was associated with malnutrition, and pain interference was associated with malnutrition, marital status, and the number of comorbidities. Hemodialysis treatment should follow a patient-tailored approach that addresses pain, nutritional status, and associated chronic conditions. In addition, pain assessment and management should be included in the curriculum of nephrology training programs.
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Affiliation(s)
- Mohammad M Jaber
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Orthopedic Surgery, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Mazen A Abdalla
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Orthopedic Surgery, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Aya Mizher
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Heba Hammoudi
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Farah Hamed
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Abrar Sholi
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Adham AbuTaha
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Department of Pathology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Mohannad Hassan
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Department of Nephrology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Sari Taha
- An-Najah Global Health Institute, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Rafiee M, Khandan M. An Investigation of the Effectiveness of Distance Learning on Nutrition Quality of Hemodialysis Patients during the COVID-19 Pandemic: A Single-Blind Randomized Clinical Trial. J Caring Sci 2024; 13:36-43. [PMID: 38659437 PMCID: PMC11036171 DOI: 10.34172/jcs.2024.33055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/04/2023] [Indexed: 04/26/2024] Open
Abstract
Introduction The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n=30) and experimental (n=30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic.
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Affiliation(s)
- Mahdieh Rafiee
- Department of Nursing, School of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Maryam Khandan
- Department of Nursing, School of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, Iran
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Ali I, Haddad D, Soliman MA, Al-Sabi A, Jebreen K, Abuzahra D, Shrara B, Ghanayem D, Natour N, Hassan M, Alsedfy MY, Shellah D, Nawajah I. Quality of life and nutritional status in peritoneal dialysis patients: a cross-sectional study from Palestine. BMC Nephrol 2024; 25:20. [PMID: 38216880 PMCID: PMC10787467 DOI: 10.1186/s12882-023-03422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/03/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND End-stage renal disease (ESRD) is a growing cause of morbidity worldwide. Protein malnutrition is common among patients with ESRD. Peritoneal dialysis (PD) offers greater lifestyle flexibility and independence compared to the widely used treatments for ESRD. This study aimed to assess the nutritional status and the quality of life (QOL) of Palestinian patients undergoing PD, as well as the variables affecting these two outcomes. METHODS A cross-sectional study was conducted on patients receiving PD at An-Najah National University Hospital, Palestine. The malnutrition-inflammation scale (MIS) was used to measure malnutrition, and the QOL score was evaluated using the Dutch WHOQOL-OLD module. Univariate and multivariate linear regressions were performed to check the association between the QOL and MIS scores. RESULTS The study included 74 patients who were undergoing PD, with an average age of 50.5 ± 16.38. The majority of the patients were females. The study found a significant correlation between malnutrition and lower quality of life (QOL) scores, as measured by the WHOQOL-OLD questionnaire (p < 0.001). Furthermore, younger patients and those who had an occupation were more likely to report a good QOL (p = 0.01). Conversely, patients with pitting edema and diabetes were at higher risk of reporting a lower QOL (p < 0.001). CONCLUSIONS Given the elevated risk of malnutrition and diminished QOL among elderly patients, those with pitting edema, and individuals with diabetes, it is imperative to conduct thorough assessments for these groups. We strongly recommend that general practitioners, dietitians, and specialists collaborate to develop tailored programs and interventions to provide these patients with the focused care and attention they require.
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Affiliation(s)
- Iyad Ali
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Dania Haddad
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, 15462, Kuwait
| | | | - Ahmed Al-Sabi
- College of Engineering and Technology, American University of the Middle East, Egaila, 54200, Kuwait
| | - Kamel Jebreen
- Unité de Recherche Clinique Saint-Louis Fernand-Widal Lariboisière, APHP, Paris, France
- Department of Mathematics, An-Najah National University, Nablus, Palestine
- Department of Mathematics, Palestine Technical University Kadoorie, Hebron, Palestine
| | - Dana Abuzahra
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Bakrieh Shrara
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Diana Ghanayem
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nihal Natour
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohanad Hassan
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - M Yasser Alsedfy
- Alexandria University Cancer Research Cluster, 21561, Alexandria, Egypt
| | - Duha Shellah
- Department of Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Inad Nawajah
- Department of Mathematics, College of Science and Technology, Hebron University, Hebron, Palestine
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Zhang X, Zhuang Y, Qin W, Yang L, Song Y. The relationship between skeletal muscle mass and exercise capacity in patients undergoing hemodialysis: An exploratory secondary-analysis. Hemodial Int 2024; 28:98-106. [PMID: 37816682 DOI: 10.1111/hdi.13115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Protein-energy wasting is commonly observed in patients undergoing hemodialysis, leading to reduced muscle mass and, in severe cases, sarcopenia, which significantly impacts the patients' quality of life and clinical outcomes. Exercise interventions are frequently employed to address muscle loss in these patients. However, the relationship between exercise capacity and skeletal muscle mass in this context remains uncertain. In this study, researchers conducted a series of body composition analysis and exercise capacity test to explore the relationship between exercise capacity and skeletal muscle mass. METHODS This study recruited 32 patients undergoing hemodialysis and analyzed their demographic and clinical parameters. To assess aerobic exercise capacity, the incremental shuttle walking test (ISWT) was conducted, while the handgrip strength test was used to evaluate muscle strength. The patients' body compositions were assessed using the Fresenius Body Composition Monitor, and the appendicular skeletal muscle was scanned using a GE Healthcare Lunar iDXA scanner. Three sequential linear models were employed to model the relationship between ISWT and skeletal muscle mass. Model 1 regressed ISWT against gender and age; Model 2 added handgrip strength, fat tissue index, and Davies comorbidity scores as additional predictors; and Model 3 further included the appendicular skeletal muscle index (appendicular skeletal muscle/height). FINDINGS After controlling for age and gender (Model 1: R2 = 0.373), and subsequently including handgrip strength, fat tissue index, and Davies comorbidity score effects (Model 2: R2 = 0.581), the impact of appendicular skeletal muscle on ISWT was found to be non-significant (Model 3: R2 = 0.600). CONCLUSION There was no significant correlation observed between exercise capacity and skeletal muscle mass in patients undergoing hemodialysis, indicating the factors influencing exercise capacity in this patient population are complex and that increasing skeletal muscle mass may not necessarily involve solely addressing the improvement of exercise capacity.
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Affiliation(s)
- Xuanrui Zhang
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, PR China
| | - Yan Zhuang
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, PR China
| | - Wen Qin
- Affiliated Hospital of Nantong University, Nantong, Jiangsu, PR China
| | - Lun Yang
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, PR China
| | - Yan Song
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, PR China
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Shakhshir M, Alkaiyat A. Healthcare providers' knowledge, attitude, and practice on quality of nutrition care in hospitals from a developing country: a multicenter experience. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:15. [PMID: 36879345 PMCID: PMC9990276 DOI: 10.1186/s41043-023-00355-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite the fact that malnutrition can affect both recovery and outcome in acute care patients, little is known about malnutrition in Palestine, and even less is known about the assessment of malnutrition knowledge, attitudes, and practices (M-KAP) toward healthcare providers and nutrition care quality measures in hospitalized patients. Therefore, this study aimed to evaluate the M-KAP of physicians and nurses in routine clinical care and determine the influencing factors. METHODS From April 1 to June 31, 2019, cross-sectional research was performed at governmental (n = 5) and non-governmental (n = 4) hospitals in the North West Bank of Palestine. Data were collected using a structured self-administered questionnaire from physicians and nurses to collect information on knowledge, attitude, and practices related to malnutrition and nutrition care, alongside sociodemographic characteristics. RESULTS A total of 405 physicians and nurses were participated in the study. Only 56% of participants strongly agreed that nutrition was important, only 27% strongly agreed that there should be nutrition screening, only 25% felt food helped with recovery, and around 12% felt nutrition as part of their job. Approximately 70% of participants said they should refer to a dietitian, but only 23% knew how and only 13% knew when. The median knowledge/attitude score was 71, with an IQR ranging from 65.00 to 75.00, and the median practice score was 15.00 with an IQR of 13.00-18.00. The mean knowledge attitude practice score was 85.62 out of 128 with SD (9.50). Respondents who worked in non-governmental hospitals showed higher practice scores (p < 0.05), while staff nurses and ICU workers showed the highest practice score (p < 0.001). Respondents with younger age categories, working in non-governmental hospitals in the ICU as practical and staff nurses, showed the highest KAP score (p < 0.05). Significance positive correlations were found between respondents' knowledge/attitude and practice scores regarding the quality of nutrition care in hospitals (r = 0.384, p value < 0.05). In addition, the result also revealed that almost half of respondents believed that the most important barriers to inadequate intake of food at the bedside are related to food appearance, taste, and aroma of meals served (58.0%). CONCLUSIONS The research revealed that inadequate knowledge was perceived as a barrier to effective nutrition care to the patient. Many beliefs and attitudes do not always translate into practice. Although the M-KAP of physicians and nurses is lower than in some other countries/studies, it highlights a strong need for more nutrition professionals in the hospital and increasing nutrition education to improve nutrition care in hospitals in Palestine. Furthermore, establishing a nutrition task force in hospitals elaborated by dietitians as the unique nutrition care provider will assure to implementation of a standardized nutrition care process.
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Affiliation(s)
- Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus, 44839 Palestine
- Health Division, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Abdulsalam Alkaiyat
- Health Division, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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AbuTaha SA, Al-Kharraz T, Belkebir S, Abu Taha A, Zyoud SH. Patterns of microbial resistance in bloodstream infections of hemodialysis patients: a cross-sectional study from Palestine. Sci Rep 2022; 12:18003. [PMID: 36289278 PMCID: PMC9605991 DOI: 10.1038/s41598-022-21979-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Bloodstream infections (BSIs) are a prominent cause of death and hospitalization among hemodialysis (HD) patients. The emergence of multidrug-resistant organisms (MDRO) is making the management of these infections more challenging. This study describes the clinical characteristics, microbial profiles and antibiotic resistance patterns in patients with BSIs. A retrospective cross-sectional study was conducted at An-Najah National University Hospital from January 2019 to December 2020. Clinical and demographic data regarding BSIs were collected from the hospital information system. Data regarding bacterial isolates and the antimicrobial resistance of BSIs were collected from the microbiology lab. Data were entered and analyzed using version 21 of the Statistical Package for Social Sciences program (IBM-SPSS). 111 BSIs occurred during the study period, with a rate of 1.5 infections per 100 patient-months. These patients had been on HD for the median duration of 747 (360, 1825) days and 62.2% had already had a BSI before the study period. 118 microorganisms were isolated; 99 (83.89%) were gram-positive and 19 (16.1%) were gram-negative. Among the gram-positive isolates, coagulase-negative staphylococci (CoNS) (88, 74.57%) were predominant. As for the gram-negative isolates, the most frequent were both Stenotrophomonas maltophilia and Escherichia coli, with five (4.23%) positive cultures each. Among the latter, two were Extended-Spectrum Beta-Lactamase producing (ESBL) (1.69%). The most frequently used empiric antibiotics were a combination of vancomycin and gentamicin (27%), followed by vancomycin alone (24.3%). Regarding gram-positive isolates, vancomycin was the most frequently used and effective antibiotic after cultures, whereas for gram-negative bacteria, it was found to be gentamicin. MDROs were defined as those resistant to at least one agent in three or more antimicrobial categories. 89 (75.4%) isolates were found to be MDRO, 85 (85.85%) gram-positive bacteria and 4 (21%) gram-negative bacteria. When comparing patients according to the type of vascular access, 66 (75%) infections with MDRO were found among patients with central venous catheters (CVCs). However, no statistically significant relationship was found between the type of vascular access and infection with MDRO (p = 0.523). MDRO cause a remarkably high proportion of BSIs in Palestinian patients. The results of this study support the empiric use of vancomycin and gentamicin to treat these infections. It is vital that health care providers prevent these infections via instituting and adhering to infection control policies in hemodialysis centers and providing proper antibiotic therapy of limited use and duration when necessary to avoid breeding resistance.
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Affiliation(s)
- Shatha A AbuTaha
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Tasbeeh Al-Kharraz
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Souad Belkebir
- Family and Community Medicine Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Adham Abu Taha
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Department of Pathology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Azzeh FS, Turkistani WM, Ghaith MM, Bahubaish LA, Kensara OA, Almasmoum HA, Aldairi AF, Khan AA, Alghamdi AA, Shamlan G, Alhussain MH, Algheshairy RM, AlShahrani AM, Qutob MS, Alazzeh AY, Qutob HM. Factors associated with the prevalence of malnutrition among adult hemodialytic patients: A two-center study in the Jeddah region, Saudi Arabia. Medicine (Baltimore) 2022; 101:e30757. [PMID: 36221328 PMCID: PMC9542565 DOI: 10.1097/md.0000000000030757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Chronic kidney disease, one of the most common diseases in the world, is characterized by irreversible impairment of the kidney's metabolic, excretory, and endocrine functions. During end-stage renal disease, patients require renal replacement therapy, such as hemodialysis (HD). Protein-energy wasting is a common health problem among HD patients. This study aims to assess the nutritional status of HD patients at two HD centers in Jeddah, Saudi Arabia, and to determine its associated factors. A cross-sectional study was conducted at two different dialysis centers in Jeddah, Saudi Arabia; 211 female and male HD patients. Malnutrition was recognized using the modified-subjective global assessment (M-SGA) comprising two parts: medical history and physical examination. Sociodemographic and health status for all patients were also determined. Patients were classified based on their M-SGA score into two groups: normal and malnourished. Overall, 54.5% of the participants showed malnutrition. Unemployment, low muscle strength and mass, high level of medication use, and high dialysis vintage were positively (P < .05) associated with malnutrition. In conclusion, the M-SGA score indicates a high prevalence of malnutrition among HD patients. These results show the importance of regular assessment and follow-ups for HD patients ensuring better health and nutritional status.
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Affiliation(s)
- Firas S. Azzeh
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- *Correspondence: Firas Azzeh, Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah 24231, Saudi Arabia (e-mail: )
| | - Waad M. Turkistani
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Clinical Nutrition Department, Diaverum A.B. Prince Abdulmajeed Dialysis Center, Jeddah, Saudi Arabia
| | - Mazen M. Ghaith
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lujain A. Bahubaish
- Clinical Nutrition Department, Diaverum A.B. North Jeddah, Jeddah, Saudi Arabia
| | - Osama A. Kensara
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Hussain A. Almasmoum
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah F. Aldairi
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Anmar A. Khan
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmad A. Alghamdi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Ghalia Shamlan
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Reham M. Algheshairy
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Saudi Arabia
| | - Abdullah M. AlShahrani
- Department of Basic Medical Sciences, College of Applied Medical Sciences, Khamis Mushayt, King Khalid University, Abha, Saudi Arabia
| | - Maysoun S. Qutob
- Clinical Nutrition and Dietetics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Awfa Y. Alazzeh
- Department of Clinical Nutrition, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Haitham M.H. Qutob
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology - Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Daraghmeh M, Badran M, Janajreh A, Hassan M, Taha AA, Koni AA, Zyoud SH. Prevalence of pruritus associated with hemodialysis and its association with sleep quality among hemodialysis patients: a multicenter study. BMC Nephrol 2022; 23:213. [PMID: 35715758 PMCID: PMC9205133 DOI: 10.1186/s12882-022-02838-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/07/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND CKD-associated pruritus (chronic kidney disease-associated pruritus) is one of the common symptoms in hemodialysis patients, with a major effect on sleep quality because it occurs at night. The main objective of this study is to determine the prevalence of pruritus among hemodialysis (HD) patients and its impact on sleep and investigate factors associated with pruritus and sleep quality. METHODS A cross-sectional study began in January until March of 2021 in HD centers of four different hospitals in the West Bank, Palestine. Patients with HD aged 18 years or older were included in our investigation. Pruritus and sleep problems were assessed by a 5-D itching score and the Pittsburgh Sleep Quality Index (PSQI) score. RESULTS Of 280 HD patients, 250 were accepted to participate in our study. The mean age of the participants was (54.9 ± 15.08). 62.8% were male, and 42.4% of the participants were elderly (age ≥ 60yrs). Pruritus was observed in 121 (48.4%). The 5-D itching score had a median [IQR] of 5.0[5.0-15.0], and 57.2% had a score ≥ 6 points. Severe pruritus was reported in 28.1% of patients. The score was significantly associated with residency (p = 0.033) and chronic comorbidities (p = 0.026). The PSQI score has a median [IQR] of 8[5-12], and 66.4% are poor sleepers with a score of < 5. The score was significantly associated with age (p = 0.017), marital status (p = 0.022), occupational status (p = 0.007), chronic comorbidities (p > 0.001), chronic medication (p = 0.008), severity of pruritus (p = 0.003) and duration of pruritus (p = 0.003). Regression analysis showed that the 5-D itching score and the total number of comorbidities were significantly associated with the PSQI score. CONCLUSIONS Pruritus is a widespread complication among HD patients in Palestine. Pruritus also has major effects on sleep quality and is associated with poor sleep quality.
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Affiliation(s)
- Mefleh Daraghmeh
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Montaser Badran
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahmad Janajreh
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohanad Hassan
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Nephrology, An-Najah National University Hospital, Nablus, 44839 State of Palestine
| | - Adham Abu Taha
- grid.11942.3f0000 0004 0631 5695Department of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Pathology, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Amer A. Koni
- grid.11942.3f0000 0004 0631 5695Division of Clinical Pharmacy, Department of Hematology and Oncology, An, Najah National University Hospital, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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9
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Laras H, Haddoum F, Baghdali FY, Gagi N, Koceir EHA, Bitam A. [Prevalence of malnutrition and absolute and functional iron deficiency anemia in nondialysis-dependent chronic kidney disease and hemodialysis Algerian patients]. Nephrol Ther 2022; 18:237-246. [PMID: 35644772 DOI: 10.1016/j.nephro.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/23/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
In chronic kidney disease, anemia and malnutrition coupled with inflammation as malnutrition-inflammation complex syndrom are common and considered as morbidity-mortality factors. The link between these two factors has been described at length in the literature highlighting an association of malnutrition with iron deficiency considered itself as one of the causes of anemia in chronic kidney disease (non-dialysis and hemodialysis). Our study aims to know the prevalence of these two factors in a population of chronic kidney disease (non-dialysis and hemodialysis) of Algiers and to highlight the possible associations between them. PATIENTS AND METHODS This is a multicentre, cross-sectional and descriptive study carried out over a period of 6months (August 2018 to January 2019). Anemia and malnutrition were assessed by various biological and clinical tools such as the malnutrition inflammation score and the International Society of Renal Nutrition and Metabolism criteria. Statistical tests were performed on the R studio software, considering P<0.05 as a statistically significant value. RESULTS Two hundred and nine patients on chronic kidney disease were included (90 non dialysis and 119 hemodialysis). The median age was 70 (IQR=16) for non dialysis and 56 (IQR=16.5) for hemodialysis. The prevalence of anemia was 66.66% (n=60) in non dialysis and 70.58% (n=84) in hemodialysis. Absolute iron deficiency anemia was higher in non dialysis (48.33%; n=29) while functional iron deficiency anemia was higher in hemodialysis (34.52%; n=29). The prevalence of malnutrition by malnutrition inflammation score was relatively low. Only functional iron deficiency anemia was associated with malnutrition. CONCLUSION The prevalence of anemia was higher in Algerian chronic kidney disease (non-dialysis and hemodialysis) unlike malnutrition which remains associated with functional iron deficiency anemia.
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Affiliation(s)
- Hayat Laras
- Département de biologie et physiologie des organismes (BPO), laboratoire de bioénergétique et métabolisme intermédiaire, Faculté des Sciences Biologiques, université des sciences et de la technologie Houari Boumediene (USTHB), Alger, Algérie; Département de médecine, faculté des sciences de la santé, laboratoire risque cardiovasculaire en néphrologie et transplantation, université d'Alger 1, Alger, Algérie.
| | - Farid Haddoum
- Département de médecine, faculté des sciences de la santé, laboratoire risque cardiovasculaire en néphrologie et transplantation, université d'Alger 1, Alger, Algérie; Service de néphrologie, hémodialyse et transplantation, Centre Hospitalier Universitaire Mustapha Pacha, Alger, Algérie
| | - Feriel-Yasmine Baghdali
- Département de médecine, faculté des sciences de la santé, laboratoire risque cardiovasculaire en néphrologie et transplantation, université d'Alger 1, Alger, Algérie; Service de néphrologie, hémodialyse et transplantation, Centre Hospitalier Universitaire Mustapha Pacha, Alger, Algérie
| | - Nadia Gagi
- Département de médecine, faculté des sciences de la santé, université d'Alger 1 et laboratoire central de biochimie, Centre Hospitalier Universitaire Mustapha Pacha, Alger, Algérie
| | - El Hadj Ahmed Koceir
- Département de biologie et physiologie des organismes (BPO), laboratoire de bioénergétique et métabolisme intermédiaire, Faculté des Sciences Biologiques, université des sciences et de la technologie Houari Boumediene (USTHB), Alger, Algérie
| | - Arezki Bitam
- Département de biologie et physiologie des organismes (BPO), laboratoire de bioénergétique et métabolisme intermédiaire, Faculté des Sciences Biologiques, université des sciences et de la technologie Houari Boumediene (USTHB), Alger, Algérie; Département de technologie alimentaire, École nationale supérieure agronomique (ENSA), Laboratoire de recherche en technologie alimentaire et nutrition humaine, El-Harrach, Alger, Algérie
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10
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Widiany FL, Sja’bani M, Susetyowati, Soesatyo M, Lestari LA, Pratiwi WR, Wahyuningsih MSH, Huriyati E. Potential Benefits of Pila ampullacea, Tempeh, Moringa oleifera Leaves as Nutritional Support for Hemodialysis. CURRENT NUTRITION & FOOD SCIENCE 2022. [DOI: 10.2174/1573401318666220401113211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background:
Hemodialysis patients can experience problems, including protein-energy malnutrition, infection, disorders of the immune system, and inflammation. One etiology of malnutrition in hemodialysis is inadequate energy and protein intake, making patients need nutritional support, which can be fulfilled by local Indonesian foodstuffs.
Objective:
This paper aimed to review the potential health benefits of snails (Pila ampullacea), tempeh, and Moringa oleifera leaves as nutritional support for hemodialysis patients.
Methods:
In this review, the methodology used was based on comprehensive data searched from PubMed for literature review and technology benchmarking in making nutritional support for hemodialysis patients. An in-depth discussion, including the advantages and drawbacks of each foodstuff, is presented and outlined. Furthermore, key solutions are proposed and presented to overcome hemodialysis issues.
Results:
The mixture of snail, tempeh, and moringa leaves as nutritional support for hemodialysis patients shows a good combination of natural ingredients from animals and plants. The nutritional content of the three mixed ingredients is found to meet the dietary requirements of hemodialysis, which are high protein, calcium and antioxidants, low phosphorus, and a phosphorus-to-protein ratio of <16.
Conclusion:
The combination of snails, tempeh, and moringa leaves provides several potential health benefits in overcoming nutritional problems, decreased immune status, and inflammation of hemodialysis patients.
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Affiliation(s)
- Fery Lusviana Widiany
- Department of Nutrition, Faculty of Health Science, Universitas Respati Yogyakarta, Indonesia
| | - Mohammad Sja’bani
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Susetyowati
- Department of Health Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Marsetyawan Soesatyo
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Lily Arsanti Lestari
- Department of Health Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Woro Rukmi Pratiwi
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Mae Sri Hartati Wahyuningsih
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Emy Huriyati
- Department of Health Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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11
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Nasir K, Sultan S, Qureshi R, Dhrolia M, Ahmad A. Mini Nutritional Assessment (MNA) as a Reliable Tool for Nutritional Assessment of Hemodialysis Patients: A Single-Center Observation. Cureus 2022; 14:e21024. [PMID: 35154994 PMCID: PMC8820469 DOI: 10.7759/cureus.21024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/05/2022] Open
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12
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Hu J, Liu Y, Heidari AA, Bano Y, Ibrohimov A, Liang G, Chen H, Chen X, Zaguia A, Turabieh H. An effective model for predicting serum albumin level in hemodialysis patients. Comput Biol Med 2022; 140:105054. [PMID: 34847387 DOI: 10.1016/j.compbiomed.2021.105054] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 12/31/2022]
Abstract
Patients on hemodialysis (HD) are known to be at an increased risk of mortality. Hypoalbuminemia is one of the most important risk factors of death in HD patients, and is an independent risk factor for all-cause mortality that is associated with cardiac death, infection, and Protein-Energy Wasting (PEW). It is a clinical challenge to elevate serum albumin level. In addition, predicting trends in serum albumin level is effective for personalized treatment of hypoalbuminemia. In this study, we analyzed a total of 3069 records collected from 314 HD patients using a machine learning method that is based on an improved binary mutant quantum grey wolf optimizer (MQGWO) combined with Fuzzy K-Nearest Neighbor (FKNN). The performance of the proposed MQGWO method was evaluated using a series of experiments including global optimization experiments, feature selection experiments on open data sets, and prediction experiments on an HD dataset. The experimental results showed that the most critical relevant indicators such as age, presence or absence of diabetes, dialysis vintage, and baseline albumin can be identified by feature selection. Remarkably, the accuracy and the specificity of the method were 98.39% and 96.77%, respectively, demonstrating that this model has great potential to be used for detecting serum albumin level trends in HD patients.
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Affiliation(s)
- Jiao Hu
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035, China.
| | - Yi Liu
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, China.
| | - Ali Asghar Heidari
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035, China.
| | - Yasmeen Bano
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, China.
| | - Alisherjon Ibrohimov
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, China.
| | - Guoxi Liang
- Department of Information Technology, Wenzhou Polytechnic, Wenzhou, 325035, China.
| | - Huiling Chen
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035, China.
| | - Xumin Chen
- Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, China.
| | - Atef Zaguia
- Department of Computer Science, College of Computers and Information Technology, Taif University, P.O. BOX 11099, Taif, 21944, Saudi Arabia.
| | - Hamza Turabieh
- Department of Information Technology, College of Computers and Information Technology, P.O. Box 11099, Taif, 21944, Taif, Saudi Arabia.
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Torreggiani M, Fois A, Njandjo L, Longhitano E, Chatrenet A, Esposito C, Fessi H, Piccoli GB. Toward an individualized determination of dialysis adequacy: a narrative review with special emphasis on incremental hemodialysis. Expert Rev Mol Diagn 2021; 21:1119-1137. [PMID: 34595991 DOI: 10.1080/14737159.2021.1987216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The search for the 'perfect' renal replacement therapy has been paralleled by the search for the perfect biomarkers for assessing dialysis adequacy. Three main families of markers have been assessed: small molecules (prototype: urea); middle molecules (prototype β2-microglobulin); comprehensive and nutritional markers (prototype of the simplified assessment, albumin levels; composite indexes as malnutrition-inflammation score). After an era of standardization of dialysis treatment, personalized dialysis schedules are increasingly proposed, challenging the dogma of thrice-weekly hemodialysis. AREAS COVERED In this review, we describe the advantages and limitations of the approaches mentioned above, focusing on the open questions regarding personalized schedules and incremental hemodialysis. EXPERT OPINION In the era of personalized dialysis, the assessment of dialysis adequacy should be likewise personalized, due to the limits of 'one size fits all' approaches. We have tried to summarize some of the relevant issues regarding the determination of dialysis adequacy, attempting to adapt them to an elderly, highly comorbidity population, which would probably benefit from tailor-made dialysis prescriptions. While no single biomarker allows precisely tailoring the dialysis dose, we suggest using a combination of clinical and biological markers to prescribe dialysis according to comorbidity, life expectancy, residual kidney function, and small and medium-size molecule depuration.
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Affiliation(s)
| | - Antioco Fois
- Nèphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France
| | - Linda Njandjo
- Nèphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France
| | - Elisa Longhitano
- Department of Clinical and Experimental Medicine, Unit of Nephrology and Dialysis, A.o.u. "G. Martino," University of Messina, Messina, Italy
| | - Antoine Chatrenet
- Nèphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France.,Laboratory "Movement, Interactions, Performance" (EA 4334), Le Mans University, Le Mans, France
| | - Ciro Esposito
- Nephrology and Dialysis, ICS Maugeri S.p.A. Sb, Pavia, Italy.,Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Hafedh Fessi
- Department of Nephrology, Hospital Tenon, Paris, France
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14
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Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: An evidence based systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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15
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Hafi E, Soradi R, Diab S, Samara AM, Shakhshir M, Alqub M, Zyoud SH. Nutritional status and quality of life in diabetic patients on hemodialysis: a cross-sectional study from Palestine. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:30. [PMID: 34225818 PMCID: PMC8256194 DOI: 10.1186/s41043-021-00255-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND End-stage renal disease (ESRD) is a leading cause of death and morbidity worldwide. Malnutrition is a common problem among hemodialysis (HD) patients that negatively impacts their prognosis and is linked to an increase in morbidity and mortality in these patients, as well as a decrease in their quality of life (QOL). In this study, we aimed to evaluate the QOL and to investigate factors that can influence it, including nutritional status, as well as socio-demographic factors, among Palestinian diabetic patients on HD therapy. METHODS This was a cross-sectional study that occurred at a large hemodialysis center in Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS), and the quality of life was evaluated by using the EuroQoL five-dimensional instrument (EQ-5D). Multivariable linear regression analysis was carried out to look at the effect of multiple variables on QOL. RESULTS A total of 118 diabetic patients on HD were included. Of these, 66.9% were male, and 60.2% were aged 60 years or higher. Having multiple comorbid diseases (p=0.004) and having been on HD for >4 years (p=0.003) were significantly associated with a higher MIS score, whereas living alone (p=0.037) and having been on HD for >4 years (p=0.002) was significantly associated with lower EQ-5D score. We also observed a significant association between the MIS score and the EQ-5D score(r=-0.616, p<0.001). Multiple linear regression analysis demonstrated that diabetic hemodialysis patients who lived within a family household were positively correlated with the QOL score (standardized coefficient, 0.178; 95% confidence interval (CI), 0.042 to 0.372; p = 0.015), and MIS score was significantly and negatively correlated with QOL scores (standardized coefficient, -0.587; 95% CI, -0.047 to -0.028; p < 0.001). CONCLUSIONS We found that malnutrition was associated with a lower QOL score among diabetic patients on HD. We recommend general practitioners, dietitians, nephrologists, and nurses to make plans that pay more attention to this group of patients who show evidence of malnutrition. Patients on dialysis for ≥ 4 years, patients who live alone, and those suffering from multiple co-morbid diseases should receive special care due to their higher risk of being impacted by this problem.
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Affiliation(s)
- Eba’a Hafi
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ro’ya Soradi
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sarah Diab
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahmad M. Samara
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Marah Shakhshir
- grid.11942.3f0000 0004 0631 5695Public Health Department, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Malik Alqub
- grid.11942.3f0000 0004 0631 5695Department of Anatomy, Biochemistry and Genetics, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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16
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Marzouq MK, Samoudi AF, Samara A, Zyoud SH, Al-Jabi SW. Exploring factors associated with pain in hemodialysis patients: a multicenter cross-sectional study from Palestine. BMC Nephrol 2021; 22:96. [PMID: 33731036 PMCID: PMC7972237 DOI: 10.1186/s12882-021-02305-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a rising medical concern around the world. End-stage kidney disease (ESKD) is the last stage of CKD stages that necessitates renal replacement therapy (RRT), such as hemodialysis (HD), which seems to be the most commonly used type. However, patients on HD still suffer from high mortality and morbidity rates compared to those who receive a kidney transplant. Therefore, we aimed in this study to assess the prevalence of pain among ESKD patients on HD, as well as to explore the factors that were associated with this complaint. METHODS We conducted a multicenter cross-sectional study in the West Bank, Palestine, between August and November 2018. We used questionnaire-based direct interviews with subjects. After reviewing previous studies in the field, we developed our questionnaire and included items on patients' social, demographic, and clinical characteristics, including dialysis-related data. It also contained the Brief Pain Inventory (BPI) to assess different aspects of pain symptoms. A convenience sampling technique was used to collect data. RESULTS Of the 300 participants, 66.3 % reported having chronic pain. HD sessions themselves were the most commonly cited cause for pain (21.6 %). The most commonly cited site of pain was the upper and lower limbs (37.3 %). Paracetamol was the most frequently used pharmacotherapy for pain alleviation. Multiple regression analysis showed that BMI (p = 0.018), gender (p = 0.023), and the number of comorbidities (p < 0.001) were independently associated with pain severity score. CONCLUSIONS Pain is a highly prevalent symptom among HD patients in Palestine. Subpopulations with higher pain severity include females, patients with higher BMI, and those with multiple comorbidities. Healthcare providers should routinely assess pain in HD patients as it is considered a significant concern. This would involve pain assessment and development of a treatment plan to improve clinical outcomes. The nephrology associations should also push for pain management in HD patients as a clinical and research priority to improve pain-related disability.
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Affiliation(s)
- Maha K. Marzouq
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
| | - Aseel F. Samoudi
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
| | - Ahmad Samara
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Centre, An-Najah National University Hospital, 44839 Nablus, Palestine
| | - Samah W. Al-Jabi
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, 44839 Nablus, Palestine
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17
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Al-Jabi SW, Sous A, Jorf F, Taqatqa M, Allan M, Sawalha L, Lubadeh E, Sweileh WM, Zyoud SH. Depression among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study from Palestine. RENAL REPLACEMENT THERAPY 2021. [DOI: 10.1186/s41100-021-00331-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
The impact of end-stage renal disease on the patient’s psychological status necessitates the value of increasing depression awareness. The current study aimed to assess the depression prevalence among Palestinian hemodialyzed patients and its association with patients’ characteristics.
Methods
A convenience clustered sampling technique was followed. Sample was collected from ten hemodialysis centers in the West Bank, Palestine, during 3 months in 2015. We used the Beck Depression Inventory-II scale (BDI-II) to evaluate depression among participants. All data were analyzed using Statistical Package for the Social Sciences version 16.0.
Results
Two hundred and eighty-six hemodialyzed patients were interviewed. The mean age (± standard deviation) of the patients was 52.0 ± 14.3 years, and most participants were males 172 (60.1%). Regarding the dialysis characteristics, the median of years of dialysis was 2 years (1–4). The prevalence of depression was 73.1%. Elderly patients (p = 0.001), female (p = 0.036), living in rural areas or camp (p = 0.032), low income (p = 0.041), unemployment (p = 0.001), not doing regular exercise (p = 0.001), and having multi comorbidities (p = 0.001) were significantly associated with more depression scores. The results of binary logistic regression showed that only patients who were living in camps, patients who were previously employed, and patients who were not practicing exercise remained significantly associated with a higher depression score.
Conclusions
This study is the first one confirmed about depression and its prevalence among hemodialyzed patients in the West Bank, Palestine. Compared to other communities, the study found a higher depression prevalence rate. There is a need to offer psychological interviews and non-pharmacological and pharmacological interventions.
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Abstract
PURPOSE OF REVIEW Chronic kidney disease (CKD) is highly prevalent in elderly patients. There is growing recognition of the importance of attention to dietary protein intake (DPI) in this population given their predisposition to age-related changes in kidney function and coexisting comorbidities (i.e., hypertension). We reviewed the impact of DPI on kidney health and survival and the role of dietary protein management in older CKD patients. RECENT FINDINGS While kidney function parameters including glomerular filtration rate (GFR) and renal plasma flow are slightly lower in elderly patients irrespective of CKD status, the kidneys' ability to compensate for increased DPI by augmentation of GFR is preserved until 80 years of age or less. However, long-term consumption of high DPI in individuals of older age and/or with CKD may contribute to kidney function deterioration over time. Prescription of a plant-dominant low-protein diet of 0.6-0.8 g/kg/day with more than 50% from plant sources or very low protein diets less than 0.45 g/kg/day supplemented with essential amino acids or their keto-analogues may be effective in preserving kidney function in older patients and their younger counterparts, while also monitoring for development of protein-energy wasting (PEW). SUMMARY Using tailored precision nutrition approaches in prescribing plant-dominant low DPI that also maintains adequate energy and nitrogen balance may ameliorate kidney function decline while also preventing development of PEW in elderly patients with CKD.
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Affiliation(s)
- Yoko Narasaki
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
| | - Connie M Rhee
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
| | - Holly Kramer
- Department of Public Health Sciences
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood
- Hines VA Medical Center, Hines, Illinois, USA
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
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Lai J, Bai YL, Bai Y, Mei J, Zhang ZW, Tang WJ, Huang J. [A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:672-680. [PMID: 33377346 PMCID: PMC7738908 DOI: 10.7518/hxkq.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/23/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. METHODS We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. RESULTS Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. CONCLUSIONS Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.
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Affiliation(s)
- Jing Lai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yuan-Liang Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yin Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Jie Mei
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Zhi-Wei Zhang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Wen-Jing Tang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Jiao Huang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
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Bramania PK, Ruggajo P, Bramania R, Mahmoud M, Furia FF. Prevalence of malnutrition inflammation complex syndrome among patients on maintenance haemodialysis at Muhimbili National Hospital in Tanzania: a cross-sectional study. BMC Nephrol 2020; 21:521. [PMID: 33256618 PMCID: PMC7708158 DOI: 10.1186/s12882-020-02171-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (> 4 years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p < 0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01–0.97), p < 0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.
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Affiliation(s)
- Puneet K Bramania
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Paschal Ruggajo
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Renal Unit, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Rimal Bramania
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Muhiddin Mahmoud
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Renal Unit, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Francis F Furia
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Renal Unit, Muhimbili National Hospital, Dar es Salaam, Tanzania
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21
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Akhlaghi Z, Sharifipour F, Nematy M, Safarian M, Malekahmadi M, Barkhidarian B, Norouzy A. Assessment of nutritional status in maintenance hemodialysis patients: A multicenter cross-sectional study in Iran. Semin Dial 2020; 34:77-82. [PMID: 33058310 DOI: 10.1111/sdi.12917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/24/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Protein-energy wasting (PEW) is common in hemodialysis patients and is linked with a high rate of morbidity and mortality. Regarding importance of nutrition in these patients, a recent study was administered to evaluate the nutritional status of hemodialysis patients. MATERIALS In this cross-sectional study 540 HD patients from 15 dialysis centers were evaluated. The nutritional status of the patients was determined by Subjective Global Assessment (SGA), Dialysis Malnutrition Score (DMS), and Malnutrition Inflammation Score (MIS). Their dietary intakes were assessed using a Food Frequency Questionnaire (FFQ). RESULT Based on DMS, 66.7% of HD patients were well nourished and the prevalence of mild-to-moderate and severe PEW were 32.4% and 0.9% in HD patients, respectively. Based on MIS, 65.2% of HD patients were well nourished and the prevalence of mild-to-moderate and severe PEW was 34.0%. The prevalence of mild-to-moderate and severe malnutrition based on SGA was 35.0% and 1.1%, respectively. Energy and protein intake in 85.6% and 80.6% of patients respectively were less than the minimum recommended amount. CONCLUSION HD patients are at risk of malnutrition and in this regard training the patient, periodic assessment of nutritional status, and referring them to a dietitian seems necessary.
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Affiliation(s)
- Zahra Akhlaghi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Sharifipour
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Malekahmadi
- Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Barkhidarian
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Bakaloudi DR, Siargkas A, Poulia KA, Dounousi E, Chourdakis M. The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review. Nutrients 2020; 12:E3071. [PMID: 33050111 PMCID: PMC7601723 DOI: 10.3390/nu12103071] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with aggravating factors which can affect both body composition and nutritional status. The purpose of the present systematic review was to investigate the potential effects of any physical activity on body composition or nutritional status among patients with stage 5 CKD undergoing hemodialysis (HD). A literature search on PubMed, Scopus, Web of Science, Google Scholar, and Cochrane was conducted and 14 randomized clinical trials were included. Skeletal muscle index and mid-arm muscular circumference increased after resistance exercise, and the results on body mass index, % body fat, and lean body mass varied. Serum albumin and C-reactive protein, in most cases, showed a slight increase and decrease, respectively. An improvement was also observed in body strength and overall performance status. The results suggest that physical activity can be beneficial for both the body composition and nutritional status of patients undergoing HD and can help in the prevention of sarcopenia. However, further research is needed mainly in the field of nutritional status.
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
| | - Antonios Siargkas
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
| | - Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
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Hemadneh MK, Khatib ST, Hasan SA, Tahboub IN, Khazneh E, Zyoud SH. Diabetes-related knowledge in diabetic haemodialysis patients: a cross-sectional study from Palestine. RENAL REPLACEMENT THERAPY 2019. [DOI: 10.1186/s41100-019-0241-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Diabetes mellitus is the leading cause of end-stage renal disease. Monitoring and controlling normal blood sugar levels play a critical role in slowing the progression of micro- and macrovascular complications of diabetes. This study was conducted to measure glycaemic control and diabetes-related knowledge in diabetic patients on maintenance haemodialysis and to assess any relationship between these two variables.
Methods
This cross-sectional study was conducted at six dialysis centres in the north of the West Bank. Blood samples were collected to measure glycated haemoglobin (HbA1c) levels, while the Michigan Diabetic Knowledge Test (MDKT) was employed as a measure tool of diabetes-related knowledge. Patients were also asked to fill in a questionnaire in order to determine their sociodemographic characteristics. Finally, univariate analyses were used to measure the associations between the clinical and sociodemographic data, and diabetes knowledge and glycaemic control.
Results
A total of 147 haemodialysis patients with diabetes were included in this study. The mean age of the cohort was 60.12 (SD = 10.28). Males accounted for 51.7% of the cohort. The HbA1c levels (%) and MDKT scores were 6.89 ± 1.72 and 9.19 ± 1.7 (mean ± SD), respectively. 36.1% of the patients had poor glycemic control. The study showed that residency and household income were associated with diabetes knowledge (P < 0.05). However, the study did not show a significant association between diabetes-related knowledge and glycaemic control overall, nor did it show a significant association between the clinical and sociodemographic factors and glycaemic control (P > 0.05).
Conclusions
This study showed that patients living in refugee camps as well as those with low income had low diabetes-related knowledge and needed extra care. This study also revealed that a relatively high proportion of diabetic patients on maintenance haemodialysis suffered from poor glycemic control. Here, we recommend to put greater emphasis on better diabetes-related knowledge as a means to achieve better diabetes care with improved glycemic control for all haemodialysis patients
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Samara AM, Sweileh MW, Omari AM, Omari LS, Dagash HH, Sweileh WM, Natour N, Zyoud SH. An assessment of sleep quality and daytime sleepiness in hemodialysis patients: a cross-sectional study from Palestine. SLEEP SCIENCE AND PRACTICE 2019. [DOI: 10.1186/s41606-019-0036-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Periodontal Disease in Patients Receiving Dialysis. Int J Mol Sci 2019; 20:ijms20153805. [PMID: 31382656 PMCID: PMC6695931 DOI: 10.3390/ijms20153805] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.
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