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Guo Y, Luo D, Yin L, Su X, Yuan Z, Huang H, Chen J. Varying association of nutrient intakes with quality of life in patients receiving different modes of dialysis. Front Cardiovasc Med 2024; 11:1407650. [PMID: 38859815 PMCID: PMC11163105 DOI: 10.3389/fcvm.2024.1407650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/30/2024] [Indexed: 06/12/2024] Open
Abstract
Background Nutrients are crucial for dialysis patients, especially elderly patients. Nutrition-related complications in dialysis patients are often closely related to cardiovascular aging. However, we know little about the effect of different nutrients on the commonly used outcome predictor, health-related quality of life (HRQOL). Therefore, this study investigated the associations between different nutrients and HRQOL among dialysis patients. Methods A cross-sectional study was conducted on 123 dialysis adults at multiple dialysis centers. The Short Form-36 Health Survey (SF-36) assesses HRQOL. Modified quantitative subjective global assessment (MQSGA) evaluates nutritional status. A 3-day dietary record evaluated nutrient intakes. Results Among the 123 participants, 79 received hemodialysis (HD), and 44 were on peritoneal dialysis (PD). Patients with PD had a higher SF-36 score than HD (525 ± 136 vs. 375 ± 179, P < 0.001). A negative association between nutrition status and HRQOL was observed in HD (regression coefficient β = -17.4, P < 0.001) but not in PD (β = -12.3, P = 0.07). For HD patients, the nutrition status was negatively correlated with intakes of carbohydrates, fiber, selenium, copper, and Manganese (β = -0.02, P = 0.032; β = -0.3, P = 0.031; β = -0.1, P = 0.006; β = -2.3, P = 0.025; β = -1.3, P = 0.003, respectively). Their HRQOL was positively associated with calories, fat, niacin, and vitamin E (β = 2.19, P = 0.035; β = 2.4, P = 0.043; β = 8.5, P = 0.044; β = 6.9, P = 0.017, respectively). Conversely, for patients with PD, only vitamin B2 was found to be adversely correlated with their nutritional status (β = -5.2, P = 0.037), and increased intakes of vitamin A, vitamin C and fiber (β = 0.1, P = 0.031; β = 0.8, P = 0.028; β = 15.8, P = 0.045, respectively) were associated with a better HRQOL. Conclusions The nutritional intake of PD patients and HD patients affects their quality of life differently. Macronutrients significantly impact HRQOL in HD patients, while vitamins have a more substantial impact on PD patients.
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Affiliation(s)
- Yadi Guo
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Dongling Luo
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Li Yin
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Xiaoyan Su
- Department of Nephrology, Dongguan Tungwah Hospital, Guangdong, China
| | - Zhimin Yuan
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hui Huang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jie Chen
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
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Foshati S, Askari G, Bagherniya M, Mortazavi M, Moeinzadeh F, Taheri S, Heidari Z, Rouhani MH. Association between nutritional, inflammatory and oxidative status (NIOS) and risk of adverse outcomes in patients on haemodialysis (HD): the NIOS-HD prospective cohort study protocol. BMJ Open 2022; 12:e064367. [PMID: 36127112 PMCID: PMC9490610 DOI: 10.1136/bmjopen-2022-064367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION The mortality of patients on chronic haemodialysis is 10-30 times greater than that of the general population and over 60% of these individuals die within the first 5 years of beginning haemodialysis. Although causes for excessive mortality in haemodialysis patients are not clearly defined, it seems that nutrition, inflammation and oxidative stress play key roles in this regard. Until now, no cohort study has focused on the association between nutritional, inflammatory or oxidative status and risk of complications and adverse outcomes in Iranian haemodialysis patients. Therefore, we sought to fill this gap and designed the Nutritional, Inflammatory, and Oxidative Status in Hemodialysis (NIOS-HD) prospective cohort study to determine the association of dietary factors, malnutrition, anthropometric indices, body composition, inflammation and oxidative stress with quality of life, dialysis access infections, hospitalisation, potential years of life lost and mortality in adults on maintenance haemodialysis in Isfahan, Iran. METHODS AND ANALYSIS The sample size of this cohort was estimated to be 300 participants. At baseline, demographic, medical and dialysis-related data of eligible patients will be recorded. In addition, participants will undergo anthropometric measurements, malnutrition assessment and body composition analysis. Also, their dietary intake and quality of life will be evaluated through interviewer-administered questionnaires. Moreover, their fasting blood samples will be collected and stored for biochemical assays including transthyretin, albumin, serum amyloid A, pentraxin-3, trimethylamine N-oxide, myeloperoxidase, paraoxonase-1 and superoxide dismutase. After baseline evaluation, patients will be followed up to 3 years to update exposure information (except biochemical assays) and measure adverse outcomes. Finally, collected data will be analysed using descriptive and inferential statistics. ETHICS AND DISSEMINATION The NIOS-HD is in agreement with the Declaration of Helsinki and has been approved by the Ethics Committee of Isfahan University of Medical Sciences (reference number: IR.MUI. RESEARCH REC.1399.605). Findings of this study will be published in academic journals.
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Affiliation(s)
- Sahar Foshati
- Nutrition and Food Security Research Center, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Mortazavi
- Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firouzeh Moeinzadeh
- Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Taheri
- Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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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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Ding Y, Chang L, Zhang H, Wang S. Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis. Nutrition 2021; 94:111527. [PMID: 34896667 DOI: 10.1016/j.nut.2021.111527] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the factors influencing sarcopenia in patients on maintenance hemodialysis (MHD) in mainland China and to explore the role of phase angle (PhA) in sarcopenia. METHODS We enrolled 346 patients on MHD with regular dialysis and collected relevant data. According to the diagnostic criteria of the Asian Sarcopenia Working Group, the patients were placed into one of two groups: sarcopenia and non-sarcopenia. The differences between groups were compared and the statistically significant factors were included in binary logistic regression analysis to screen for independent factors influencing sarcopenia. Receiver operating characteristic curve and area under the curve were used to evaluate the predictive value of PhA in sarcopenia. RESULTS The prevalence of sarcopenia was 32.66% in patients on MHD. Logistic regression analysis showed that sarcopenia was significantly associated with age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.08-1.15; P < 0.001), body mass index (OR, 0.66; 95% CI, 0.58-0.76; P < 0.001), and PhA (OR, 0.24; 95% CI, 0.15-0.40; P < 0.001). The best cutoff value of PhA on sarcopenia was 4.67° for both sexes, 4.67° and 4.60° for men and women, respectively (P < 0.001). CONCLUSION The present study showed that PhA was an important influencing factor of sarcopenia adjusted by age and body mass index in Asian patients on MHD. PhA may have an optimistic predictive value to identify sarcopenia in these population, and it is convenient and accessible in clinical practice than the diagnostic criteria of sarcopenia.
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Affiliation(s)
- Yan Ding
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Liyang Chang
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
| | - Hongmei Zhang
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Shaoling Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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The Relationship Between Nutritional Status Based on Subjective Global Assessment and Dialysis Adequacy. Nephrourol Mon 2021. [DOI: 10.5812/numonthly.116254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Malnutrition is common in patients undergoing hemodialysis and leads to a decrease in dialysis adequacy. The evaluation of dialysis adequacy is very important. Objectives: This study was done to investigate the relationship between patients’ nutrition status based on Subjective Global Assessment (SGA) and their dialysis adequacy. Methods: This cross-sectional descriptive study was conducted in Tehran, Iran, in 2019. Three hundred qualified patients were selected by cluster sampling. Before the dialysis session, measurement of height and weight and blood sampling for albumin, total iron-binding capacity (TIBC), blood urea nitrogen (BUN), and creatinine (Cr) assessment were performed. After the dialysis session, measurement of weight and second sampling for BUN were done. SGA forms were filled by patients. Patients’ dialysis adequacy was calculated based on the DaugirdasII formula, and data were analyzed using SPSS 21. Results: From 300 patients, 128 cases (42.7%) had normal nutrition status, while 148 cases (49.3%) had mild to moderate malnutrition and 24 cases (8%) had severe malnutrition with mean dialysis adequacy of 1.07. The present study showed a significant statistical relationship between malnutrition and education (P < 0.001), body mass index (BMI) (P = 0.03), albumin (P < 0.001), TIBC (P < 0.001), and dialysis adequacy (P < 0.001). Gender, age, and dialysis duration showed no significant relationship with nutrition status based on the SGA index. Conclusions: The findings showed a high relative frequency of malnutrition and a decrease in patients’ dialysis adequacy, which emphasize the patient’s educational level, proper management of nutrition along with regular consultations by nutritionists, better implementation of the dialysis procedure, and regular follow-up of dialysis adequacy.
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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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Hedayati S, Nachvak SM, Samadi M, Motamedi-Motlagh A, Moradi S. Malnutrition and nutritional status in critically ill patients with enteral nutrition. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200421] [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 & OBJECTIVE: The prevention of malnutrition is an important factor in the survival of critically ill patients with enteral nutrition. The present study aims to assess the nutritional status and its association with some blood-related markers in critically ill patients with enteral nutrition during hospitalization in the intensive care units (ICUs). METHODS: Totally, 110 patients participated in this study from the time of admission to discharge at five ICUs. The patients’ nutritional status was assessed by subjective global assessment (SGA), Acute Physiology and Chronic Health Evaluation and Albumin, Total Iron Binding Capacity (TIBC), Hemoglobin (Hb), Hematocrit (HCT), Ferritin, and Feas biochemical indices and anthropometric parameters. RESULTS: Malnutrition prevalence increased significantly on the day of discharge (83.6%) compared to the day of admission (41.8%), according to SGA (P < 0.001). Hb, HCT, serum Fe decreased and ferritin, also TIBC were increased during hospitalization in ICU. The malnutrition risk predictors based on the logistic regression were low levels of Hb (OR = 0.6), HCT (OR = 0.9), Fe (OR = 0.9), Albumin (OR = 0.3) and High Ferritin level (OR = 1.006) on the admission day. Anemia of inflammation (AI) was observed during ICU stay. CONCLUSION: This study demonstrated that malnutrition is an increasing phenomenon in the ICU patients and the delay in patient’s enteral feeding had a direct influence in the prevalence of malnutrition on discharge day.
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Affiliation(s)
- Safoora Hedayati
- Department of Nutrition, School of Nutrition Science and Food Technology, Committee of the Deputy of Research and Technology of Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyyed Mostafa Nachvak
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehnoosh Samadi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Shima Moradi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abstract
Background Pain is a common complaint among hemodialysis (HD) patients; however, most patients are not assessed for this aspect and are not sufficiently treated. In these patients, pain is reported to be associated with a range of parameters like increased depression and disrupted quality of life (QOL). Previously residual renal function (RRF) was not assessed for associations with pain. The primary aim of the study is to evaluate the pain frequency in the Turkish HD patient population. In addition, the type, origin, and severity of chronic pain, the pain treatment ratio, and the relationship between pain, QOL, and RRF were investigated during the study. Methods This study included 328 HD patients. Pain assessment used the McGill Pain Questionnaire and neuropathic pain assessment used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. The correlation of pain and quality of life was evaluated with the Short Form 36 (SF-36) quality of life scale. Results Of patients, 244 experienced pain (74.4%), and this pain had a neuropathic character in 61.8% of these patients. Patients with pain had a longer dialysis duration than those without pain (4.00 (2.00-8.00), 3.00 (2.00-4.75), p=0.01). The most common site of pain was the lower extremities. Pain was observed more often among females and with increasing age. Only 36.4% of patients used analgesics. The quality of life of patients with pain was found to be lower. The incidence of pain was higher among patients without RRF and had more neuropathic character. Conclusions Pain is a significant problem for the majority of HD patients and is not effectively managed. To increase the quality of life of patients, the care team should regularly question pain symptoms, and it should be treated effectively. In this context, RRF should be regularly monitored and efforts should be made to preserve it.
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Affiliation(s)
- Esmira Sadigova
- Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, TUR
| | - Sultan Ozkurt
- Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, TUR
| | - Ahmet Ugur Yalcin
- Internal Medicine: Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, TUR
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Abstract
INTRODUCTION Chronic kidney disease patients often also present protein-calorie malnutrition, and it is a powerful predictor of morbidity and mortality. In this article, causes and management are shown, highlighting oral and parenteral nutritional supplementation, especially during dialysis process.
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Malnutrition in Hemodialysis Patients and Predicting Factors: A Cross-Sectional Study. Nephrourol Mon 2019. [DOI: 10.5812/numonthly.86586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Günalay S, Öztürk YK, Akar H, Mergen H. The relationship between malnutrition and quality of life in haemodialysis and peritoneal dialysis patients. ACTA ACUST UNITED AC 2019; 64:845-852. [PMID: 30673007 DOI: 10.1590/1806-9282.64.09.845] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/06/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND One of the most important factors affecting the quality of life of chronic kidney disease (CKD) patients is nutrition. Prevention of malnutrition increases patients' quality and length of life. In this study, we aimed to determine the frequency of malnutrition, quality of life, and the relationship between them in patients with end-stage renal disease (ESRD). METHOD The study was conducted with a total of 60 CKD patients including 50 haemodialysis patients and 10 peritoneal dialysis patients. Patients' data associated with socio-demographics, body mass index (BMI), waist circumference, triceps skin-fold thickness (TSFT), pre-dialysis systolic and diastolic blood pressure, Kt/V and urea reduction ratio (URR) values, laboratory parameters, Mini-Nutritional Assessment-Short Form (MNA-SF) and European Quality of Life 5-Dimensions (EQ5D) scale were recorded. FINDINGS Of the total 60 patients; 27 were male (45%), 33 were female (55%), 83.3% were receiving haemodialysis treatment (HD), and 16.7% were receiving peritoneal dialysis treatment (PD). The mean MNA-SF score was 10.4 ± 2.8 in the HD group and 10.5 ± 2.9 in the PD group; there was no difference between the scores of the HD and PD groups. The mean EQ5D score was 0.60 ± 0.29 in the HD group and 0.68 ± 0.33 in the PD group, no significant difference was found between the HD group and the PD group. The quality of life was found lower in malnourished group (p=0.001). CONCLUSION The quality of life needs to be increased by early diagnosis and treatment of malnutrition in patients at risk.
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Affiliation(s)
- Serkan Günalay
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Yasemin Kiliç Öztürk
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Harun Akar
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir,Turkey
| | - Haluk Mergen
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
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Vijaya KL, Aruna M, Narayana Rao SVL, Mohan PR. Dietary Counseling by Renal Dietician Improves the Nutritional Status of Hemodialysis Patients. Indian J Nephrol 2019; 29:179-185. [PMID: 31142964 PMCID: PMC6521776 DOI: 10.4103/ijn.ijn_272_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Proper nutrition may reverse the malnutrition and can modulate renal function in hemodialysis patients. In majority of the dialysis units in India, nutritional advice is given by health professionals working in dialysis. We compared the impact of dietary counseling by a renal dietitian, on nutritional status with that by health professionals working in dialysis units in patients undergoing maintenance hemodialysis. Nutritional assessments were made using subjective global assessment (SGA) scale, which combines assessment of intake, physical findings, and functional status. Two hundred and seventy-seven patients undergoing hemodialysis from two renal care units in Nellore, Andhra Pradesh, South India, were enrolled (138 patients in control group, 139 in experimental group). In the experimental group, patients were given repeated dietary counseling by a renal dietician, whereas control group patients were provided with the necessary nutritional information by another health professional. Detailed nutritional, biochemical, and SGA assessment were done on all of them at the beginning and completion of study after 6 months. Patients were categorized as well-nourished (WN) (SGA = 1–14), mild to moderate malnourishment (MMM) (SGA = 15–35), and severe malnutrition (SM) (SGA = 36–49). In the present study, the overall malnutrition rate at baseline was 95.3%, and it dropped down to 91.7% after 6 months after nutritional counseling. In the experimental group, malnutrition status decreased from 97.2% to 89.8%, whereas in the control group, malnutrition situation remained same. Compared to baseline, in the control group, there was no improvement in the WN group. However, a shift has been observed from MMM group to SM group suggesting more number of patients are becoming malnourished. Contrarily, in the experimental group, an improvement of +7.2% in WN group and +14.3% in MMM group and a drop of −21.6% in severe malnourished group suggesting more number of patients gaining nutrition. The present study observed a significant improvement in nutritional status of patients who received counseling by the renal dietician. The reduction in SGA score was independent of reductions in serum creatinine and blood urea levels.
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Affiliation(s)
- K L Vijaya
- Department of Nutrition, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - Mesa Aruna
- Department of Home Science, Sri Padmavati Mahila University, Tirupati, Andhra Pradesh, India
| | - S V L Narayana Rao
- Aravind Kidney Centre, Narayana Medical College, Nellore, Andhra Pradesh, India
| | - Pathapati Rama Mohan
- Department of Pharmacology, Narayana Medical College, Nellore, Andhra Pradesh, India
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Subjective Global Assessment-Dialysis Malnutrition Score and cardiovascular risk in hemodialysis patients: an observational cohort study. J Nephrol 2018; 31:757-765. [PMID: 29936648 DOI: 10.1007/s40620-018-0505-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/08/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Malnutrition is an important risk factor for cardiovascular mortality in hemodialysis (HD) patients. However, current malnutrition biomarkers seem unable to accurately estimate the role of malnutrition in predicting cardiovascular risk. Our aim was to investigate the role of the Subjective Global Assessment-Dialysis Malnutrition Score (SGA-DMS) compared to two well-recognized comorbidity scores-Charlson Comorbidity Index (CCI) and modified CCI (excluding age-factor) (mCCI)-in predicting cardiovascular events in HD patients. METHODS In 86 maintenance HD patients followed from June 2015 to June 2017, we analyzed biohumoral data and clinical scores as risk factors for cardiovascular events (acute heart failure, acute coronary syndrome and stroke). Their impact on outcome was investigated by linear regression, Cox regression models and ROC analysis. RESULTS Cardiovascular events occurred in 26/86 (30%) patients during the 2-year follow-up. Linear regression showed only age and dialysis vintage to be positively related to SGA-DMS: B 0.21 (95% CI 0.01; 0.30) p 0.05, and B 0.24 (0.09; 0.34) p 0.02, respectively, while serum albumin, normalized protein catabolic rate (nPCR) and dialysis dose (Kt/V) were negatively related to SGA-DMS: B - 1.29 (- 3.29; - 0.81) p 0.02; B - 0.08 (- 1.52; - 0.35) p 0.04 and B - 2.63 (- 5.25; - 0.22) p 0.03, respectively. At Cox regression analysis, SGA-DMS was not a risk predictor for cardiovascular events: HR 1.09 (0.9; 1.22), while both CCI and mCCI were significant predictors: HR 1.43 (1.13; 1.87) and HR 1.57 (1.20; 2.06) also in Cox adjusted models. ROC analysis reported similar AUCs for CCI and mCCI: 0.72 (0.60; 0.89) p 0.00 and 0.70 (0.58; 0.82) p 0.00, respectively, compared to SGA-DMS 0.56 (0.49; 0.72) p 0.14. CONCLUSIONS SGA-DMS is not a superior and significant prognostic tool compared to CCI and mCCI in assessing cardiovascular risk in HD patients, even it allows to appraise both malnutrition and comorbidity status.
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Spatola L, Finazzi S, Calvetta A, Angelini C, Badalamenti S. Subjective Global Assessment-Dialysis Malnutrition Score and arteriovenous fistula outcome: A comparison with Charlson Comorbidity Index. J Vasc Access 2018; 20:70-78. [PMID: 29874975 DOI: 10.1177/1129729818779550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION: Malnutrition is a well-recognized risk factor for all-cause mortality in hemodialysis patients. However, its role for arteriovenous fistulas outcome has not been exhaustively investigated. Our aim was to point out the impact of Subjective Global Assessment-Dialysis Malnutrition Score as independent predictor of arteriovenous fistulas thrombosis (vascular access thrombosis) and/or significant stenosis (vascular access stenosis). In addition, we compared it with the widespread Charlson Comorbidity Index. METHODS: We assessed 57 hemodialysis patients for a 2-year interval and evaluated the incidence of vascular access thrombosis and/or stenosis. Linear regression analysis was used to test the relation of variables with Subjective Global Assessment-Dialysis Malnutrition Score at baseline. Logistic and Cox regression analysis evaluated markers as predictors of both vascular access thrombosis and stenosis. Receiver operating characteristic curve analysis was used to compare area under the curve values of Subjective Global Assessment-Dialysis Malnutrition Score, Charlson Comorbidity Index, and modified Charlson Comorbidity Index. RESULTS: Age and Charlson Comorbidity Index were positively related to Subjective Global Assessment-Dialysis Malnutrition Score: B = 0.06 (95% CI = 0.01; 0.11) and B = 0.31 (95% CI = 0.01; 0.63). Higher albumin and normalized protein catabolic rate levels had a protective role against vascular access failure: OR = 0.67 (95% CI = 0.56; 0.81) and OR = 0.46 (95% CI = 0.32; 0.67), respectively. Higher Subjective Global Assessment-Dialysis Malnutrition Score and Charlson Comorbidity Index values were significant risk factors: HR = 1.42 (95% CI = 1.04; 1.92) and HR = 1.48 (95% CI = 1.01; 2.17), respectively. Area under the curve of Subjective Global Assessment-Dialysis Malnutrition Score was significantly higher than those of both Charlson Comorbidity Index and modified Charlson Comorbidity Index: 0.70 (95% CI = 0.50; 0.88) versus 0.61 (95% CI = 0.41; 0.80) and 0.55 (95CI% = 0.41; 0.70). CONCLUSION: Subjective Global Assessment-Dialysis Malnutrition Score, as well as Charlson Comorbidity Index, are useful tools to predict vascular access failure and should be carefully and periodically evaluated in order to check significant variations that may compromise vascular access survival.
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Affiliation(s)
- Leonardo Spatola
- 1 Humanitas, Clinical and Research Center, Renal and Hemodialysis Unit, Rozzano (MI), Italy
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Kirushnan BB, Rao BS, Annigeri R, Balasubramanian S, Seshadri R, Prakash KC, Vivek V. Impact of Malnutrition, Inflammation, and Atherosclerosis on the Outcome in Hemodialysis Patients. Indian J Nephrol 2017; 27:277-283. [PMID: 28761229 PMCID: PMC5514823 DOI: 10.4103/0971-4065.202830] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Malnutrition, inflammation, and atherosclerosis are significant problems in patients on hemodialysis. A prospective, observational study in 100 hemodialysis patients for 2 years was conducted. The primary outcomes were hospitalizations and mortality at the end of 2 years. The mean age was 61 ± 11.3 years and 69% were male. Seven patients did not complete the study (five underwent transplant and two were shifted to other units). Serum albumin was significantly lower in malnourished patients at 6 months from the beginning of the study period (3.58 vs. 3.79 g/dl, P = 0.001). Malnutrition based on subjective global assessment (SGA) was seen in 30 (32%) patients: mild to moderate in 27 (29%) and severe in 3 (3%). Inflammation was seen in 73 (78.5%) patients and intimal-medial thickness of >1.1 mm indicating significant atherosclerosis was seen in 73 (78.5%) patients. Modified SGA score and malnutrition-inflammation score (MIS) were significantly more in the malnourished group. Statistically significant association was seen between hospitalization and mortality in the malnourished population, and the odds ratio of death in malnourished patients was 9.83 (95% confidence interval: 2.8-34.3, P < 0.001). There was a moderate correlation between malnutrition assessed by modified SGA and MIS score (r = 0.54, P < 0.001). Mortality rate was 37% in patients with mild to moderate and 67% in severe malnutrition. Hospital admission was seen in 43 (46%) patients and was significantly more common in malnourished compared to well-nourished patients (77% vs. 32%, P < 0.001). Multiple logistic regression analysis showed that malnutrition by Modified SGA was the only significant variable associated with mortality at 2 years, and addition of MIS score did not improve the predictive ability of the model to modified SGA. We recommend the use of modified SGA and serial serum albumin to monitor nutrition in hemodialysis patients.
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Affiliation(s)
- B B Kirushnan
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - B Subba Rao
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - R Annigeri
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - S Balasubramanian
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - R Seshadri
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - K C Prakash
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - V Vivek
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
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Ilić Begović T, Radić J, Radić M, Kovačić V, Šain M, Ljutić D. Seasonal Variations of Nutritional Status in Maintenance Hemodialysis Patients. Ther Apher Dial 2016; 20:468-475. [DOI: 10.1111/1744-9987.12405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/27/2015] [Accepted: 12/17/2015] [Indexed: 01/30/2023]
Affiliation(s)
- Tanja Ilić Begović
- Intensive Care Unit of the Department of Internal Medicine, School of Medicine in Split; University Hospital Centre Split; Split Croatia
| | - Josipa Radić
- Division of Nephrology and Dialysis, School of Medicine in Split; University Hospital Centre Split; Split Croatia
| | - Mislav Radić
- Division of Rheumatology and Clinical Immunology, School of Medicine in Split; University Hospital Centre Split; Split Croatia
| | - Vedran Kovačić
- Intensive Care Unit of the Department of Internal Medicine, School of Medicine in Split; University Hospital Centre Split; Split Croatia
| | - Milenka Šain
- Division of Nephrology and Dialysis, School of Medicine in Split; University Hospital Centre Split; Split Croatia
| | - Dragan Ljutić
- Division of Nephrology and Dialysis, School of Medicine in Split; University Hospital Centre Split; Split Croatia
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Knap B, Arnol M, Romozi K, Marn Pernat A, Gubenšek J, Ponikvar R, Buturović-Ponikvar J, Večerić-Haler Ž. Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis. Ther Apher Dial 2016; 20:272-6. [DOI: 10.1111/1744-9987.12436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/23/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Bojan Knap
- Department of Nephrology; University Medical Center Ljubljana; Slovenia
| | - Miha Arnol
- Department of Nephrology; University Medical Center Ljubljana; Slovenia
| | - Karmen Romozi
- Department of Nephrology; University Medical Center Ljubljana; Slovenia
| | | | - Jakob Gubenšek
- Department of Nephrology; University Medical Center Ljubljana; Slovenia
| | - Rafael Ponikvar
- Department of Nephrology; University Medical Center Ljubljana; Slovenia
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Ekramzadeh M, Mazloom Z, Jafari P, Ayatollahi M, Sagheb MM. Major barriers responsible for malnutrition in hemodialysis patients: challenges to optimal nutrition. Nephrourol Mon 2014; 6:e23158. [PMID: 25738117 PMCID: PMC4330668 DOI: 10.5812/numonthly.23158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/10/2014] [Indexed: 01/30/2023] Open
Abstract
Background: Nutritional barriers may contribute to malnutrition in hemodialysis (HD) patients. Higher rates of morbidity and mortality rates have been reported in malnourished HD patients. These patients are faced with different challenges affecting their nutritional status. Objectives: The aim of this cross-sectional study was to identify most important barriers responsible for malnutrition in HD patients. Patients and Methods: We randomly selected 255 of 800 stable HD patients from three HD centers with an age range of 18-85 years, who had been on hemodialysis for at least three months without any acute illness. Each patient was interviewed to evaluate malnutrition [subjective global assessment (SGA), malnutrition inflammation score (MIS)], and potential medical, behavioral and socioeconomic barriers. Body composition of patients was checked through bioelectrical impedance analysis (BIA). Routine clinical markers of malnutrition such as serum albumin and total protein were measured using standard automated techniques. Binary logistic regression model was used to find the association between nutritional markers and potential barriers. Results: Patients with higher SGA had lower knowledge about general nutrition [odds ratio (OR), 1.3], potassium (OR, 1.89), difficulty chewing (OR, 1.16), and shopping (OR, 1.16). Those with greater MIS scores had poor appetite (OR, 1.3), depression (OR, 1.21), and difficulty with cooking (OR, 1.15). Lower BCM (body cell mass) was associated with poor appetite (OR, 0.92) and needed help for cooking (OR, 0.88). Patients with higher BFMI (body fat mass index) had insufficient general nutrition (OR, 1.15), and protein (OR, 1.27) knowledge, and needed help for shopping (OR, 1.14). Moreover, patients with higher SGA scores were those with older age and longer duration of HD. Conclusions: Three medical barriers (poor appetite, depression and difficulty chewing), one behavioral barrier (poor total nutrition, protein, and potassium knowledge), and one socioeconomic barrier (needing help for shopping and cooking) were independently associated with nutritional markers.
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Affiliation(s)
- Maryam Ekramzadeh
- Department of Clinical Nutrition, Shiraz School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Zohreh Mazloom
- Department of Clinical Nutrition, Shiraz School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Zohreh Mazloom, Department of Clinical Nutrition, Shiraz School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7117251001, Fax: +98-7117260225, E-mail:
| | - Peyman Jafari
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Maryam Ayatollahi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Mohammad Mahdi Sagheb
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Espahbodi F, Khoddad T, Esmaeili L. Evaluation of malnutrition and its association with biochemical parameters in patients with end stage renal disease undergoing hemodialysis using subjective global assessment. Nephrourol Mon 2014; 6:e16385. [PMID: 25032136 PMCID: PMC4090668 DOI: 10.5812/numonthly.16385] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 12/21/2013] [Accepted: 01/11/2014] [Indexed: 01/30/2023] Open
Abstract
Background: Malnutrition is a common problem in patients with end stage renal disease (ESRD) undergoing hemodialysis that increases morbidity and mortality rate in them. Subjective global assessment (SGA) is a tool used by health care providers to assess nutritional status in these patients. In addition, biochemical parameters are used to assess the nutritional status in all people. Objectives: In this study, we evaluated the nutritional status of patients with ESRD undergoing hemodialysis using SGA and assessed probable association between biochemical parameters and malnutrition in this population. Patients and Methods: Using SGA, the nutritional status of 105 patients (60 males and 45 females) of two dialysis centers in Sari, Iran, was evaluated during years 2007-2008. It is a semiquantitative scoring system that has seven variables derived from medical history and physical examination. The biochemical parameters including hemoglobin, albumin, cholesterol, BUN, and creatinine were also measured. Results: Among 105 patients, 98 (93.33%) patients consisted of 56 males and 42 females had mild to moderate malnutrition and 3 (2.86%) women had severe malnutrition. In addition, all of the patients without malnutrition were men. We found significant association between patient’s sex and the SGA score (P = 0.03) but no significant association was seen between age and duration of hemodialysis with SGA score. In addition, we did not find significant association between the measured biochemical parameters and malnutrition. Conclusions: According to high prevalence of malnutrition in our patients with ESRD undergoing hemodialysis, periodic assessment of nutritional status is necessary in them. Meanwhile we found SGA as the best tool to assess nutritional status in patients with ESRD undergoing hemodialysis, because it can recognize various degrees of malnutrition that may remain undetected by a single laboratory assessment.
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Affiliation(s)
- Fatemeh Espahbodi
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Talayeh Khoddad
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding author: Talayeh Khoddad, Clinical Research Center of Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-9113553370, Fax: +98-1512264044, E-mail:
| | - Leila Esmaeili
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
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Gokcek D, Tran JD, Gonzalez-Aguilar A, Alentorn A, Liou A, Delattre JY, Idbaih A. Évaluation du statut nutritionnel chez les patients présentant un glioblastome en récidive. Rev Neurol (Paris) 2013; 169:892-7. [DOI: 10.1016/j.neurol.2012.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 10/04/2012] [Accepted: 10/23/2012] [Indexed: 01/30/2023]
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Chen J, Peng H, Zhang K, Xiao L, Yuan Z, Chen J, Wang Z, Wang J, Huang H. The insufficiency intake of dietary micronutrients associated with malnutrition-inflammation score in hemodialysis population. PLoS One 2013; 8:e66841. [PMID: 23825573 PMCID: PMC3692507 DOI: 10.1371/journal.pone.0066841] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/13/2013] [Indexed: 01/30/2023] Open
Abstract
The relations between dietary micronutrient, nutritional status and inflammation in hemodialysis patients are still unclear. A cross-sectional study was performed in hemodialysis population. 75 hemodialysis patients from South China participated in the dietary and nutritional assessment. Clinical and dietary data were collected. Nutritional status was assessed by Malnutrition-Inflammation Score (MIS) in addition to related anthropometric measurements. And according to the MIS score, the whole hemodialysis patients were divided into normal nutrition group and malnutrition group. The results showed that mid arm circumference (MAC) negatively correlated with MIS (r = −0.425; P = 0.002). The area under the ROC curve (AUC) for MAC was 0.737 (0.614–0.859). Comparing with the normal nutritional group, lower dietary selenium (Se), copper (Cu), iodine (I) and manganese (Mn) intake were observed among patients with malnutrition (P<0.05). While no significant differences of diverse vitamins were found. In conclusion, MAC was effective indicator for assessing nutritional and inflammatory status (P<0.05). The reduction of dietary Se, Cu, I and Mn intake level may be alarming markers for malnutrition and inflammatory status in hemodialysis patients.
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Affiliation(s)
- Jie Chen
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong Province, China
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | | | - Kun Zhang
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong Province, China
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Long Xiao
- Department of Blood Purification of the Second Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong Province, China
| | - Zhimin Yuan
- Department of Nutrition, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jianping Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Zhiyu Wang
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Jingfeng Wang
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong Province, China
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Hui Huang
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong Province, China
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
- * E-mail:
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Roy LG, Shetty MS, Urooj A. EFFECT OF NUTRITIONAL INTERVENTION ON MALNUTRITION INDICATORS IN PATIENTS ON HAEMODIALYSIS. J Ren Care 2013; 39:39-46. [DOI: 10.1111/j.1755-6686.2013.12000.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Linda Grace Roy
- Department of Studies in Food Science and Nutrition; University of Mysore; Mysore-570 006, Karnataka; India
| | | | - Asna Urooj
- Department of Studies in Food Science and Nutrition; University of Mysore; Mysore-570 006, Karnataka; India
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