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nutrition in dialysis

Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Matthew Tabinor, Emma Elphick, Michael Dudson, Chun Shing Kwok, Mark Lambie, Simon J Davies
Both overhydration and comorbidity predict mortality in end-stage kidney failure (ESKF) but it is not clear whether these are independent of one another. We undertook a systematic review of studies reporting outcomes in adult dialysis patients in which comorbidity and overhydration, quantified by whole body bioimpedance (BI), were reported. PubMed, EMBASE, PsychInfo and the Cochrane trial database were searched (1990-2017). Independent reviewers appraised studies including methodological quality (assessed using QUIPS)...
March 13, 2018: Scientific Reports
Ye-Ping Jiang, Ying Shen, Xiao-Rong Liu
OBJECTIVE: To investigate the nutritional status of children on maintenance hemodialysis due to stage 5 chronic kidney disease (CKD) and the clinical significance of nutritional assessment indices. METHODS: A total of 21 children on maintenance hemodialysis due to stage 5 CKD were grouped according to body mass index. The nutritional status was assessed based on anthropometric parameters, biochemical parameters, inflammatory factors, residual renal function, indices of dialysis adequacy, and resting energy expenditure...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Bahar Gürlek Demirci, Siren Sezer, Emre Tutal, Turan Çolak, Saliha Uyanık, Mehmet Haberal
OBJECTIVES: In kidney transplant recipients, reduced muscle mass and hand-grip strength are associated with impaired nutritional status. Serum testosterone is highly associated with muscle strength in the general population. Here, we aimed to determine the associations among serum testosterone, hand-grip strength, and nutritional and inflammatory parameters, as well as graft function. MATERIALS AND METHODS: Our study included 144 stable male kidney transplant recipients from our renal transplant outpatient clinic...
March 2018: Experimental and Clinical Transplantation
Thijs Thomas Jansz, Akin Özyilmaz, Muriel P C Grooteman, Tiny Hoekstra, Marieke Romijn, Peter J Blankestijn, Michael L Bots, Brigit C van Jaarsveld
OBJECTIVES: Nocturnal haemodialysis (NHD), characterised by 8-hour sessions ≥3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3×3.5-4 hours a week. We studied long-term effects of NHD and used patients on conventional HD/haemodiafiltration (HDF) as controls. DESIGN: Four-year prospective follow-up of patients who switched to NHD; we compared patients with patients on HD/HDF using propensity score matching...
March 8, 2018: BMJ Open
Katarzyna Wyskida, Jarosław Wajda, Dariusz Klein, Joanna Witkowicz, Rafał Ficek, Sylwia Rotkegel, Urszula Spiechowicz-Zatoń, Joanna Kocemba-Dyczek, Jarosław Ciepał, Magdalena Olszanecka-Glinianowicz, Andrzej Więcek, Jerzy Chudek
BACKGROUND: Diet is a key factor that determines proper alignment of calcium-phosphate and nutritional status among hemodialysis (HD) patients. OBJECTIVES: To assess the nutrient intake in relation to long-term calcium-phosphate control in HD patients with end-stage renal failure. MATERIAL AND METHODS: The study included 107 patients (66 men, 41 women) from 10 dialysis centers in the Upper Silesia region of Poland. To analyze the diet composition during the previous year, a portion-sized version of the Diet History Questionnaire II (DHQ-II) from National Institutes of Health was used...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
R Jhorawat, N Bansal, P Beniwal, D Agarwal, V Malhotra
The aim of this study was to measure insulin resistance (IR) in dialysis patients and its relation to Vitamin D status and nutritional parameters. We included patients on maintenance dialysis, both hemodialysis and peritoneal dialysis (HD and PD). IR was measured by homeostatic model assessment (HOMA)-IR index defined as fasting serum insulin (μU/L) × fasting blood sugar (mmol/L)/22.5. Baseline Vitamin D levels were measured by chemiluminescence immunoassay (CLIA) method. HOMA-IR index correlated with nutritional parameters such as 7-point subjective global assessment (SGA) and anthropometric measures, for example, body fat percentage, lean body weight (LBW), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC)...
January 2018: Indian Journal of Nephrology
Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Franz Maximilian Rasche, Ronny Rettig, Thomas Frese, Wilma Gertrud Rasche, Filip Barinka, Guenter Roesl, Frieder Keller, Tom H Lindner, Jochen G Schneider, Joachim Beige, Thomas Ebert, Stephan Schiekofer
INTRODUCTION: Endocrine disorders of the pituitary axes are frequent in patients with hemodialysis (CKD5D). The aim of this multicenter study (Leipzig (L), Quedlinburg and Blankenburg in the Harz region (Hz)) in CKD5D patients was to evaluate influences of CKD5D related factors, morphological and biochemical parameters, and serum iodine and prolactin concentrations on the pituitary-thyroid axis. PATIENTS AND METHODS: 170 patients (L n=58; Hz n=112) were included in this prospective, non-interventional, cross-sectional study...
February 23, 2018: Experimental and Clinical Endocrinology & Diabetes
Karin Windahl, Gerd Faxén Irving, Tora Almquist, Maarit Korkeila Lidén, Moniek van de Luijtgaarden, Nicholas C Chesnaye, Pauline Voskamp, Peter Stenvinkel, Marian Klinger, Maciej Szymczak, Claudia Torino, Maurizio Postorini, Christiane Drechsler, Fergus J Caskey, Christoph Wanner, Friedo W Dekker, Kitty J Jager, Marie Evans
OBJECTIVES: Prevalence and risk factors for protein-energy wasting (PEW) are poorly studied in the nondialysis, older population with advanced chronic kidney disease (CKD). Our aim was to evaluate the prevalence of PEW in advanced stage CKD patients aged greater than 65 years. Furthermore, we aimed to describe risk factors for PEW in the overall study population and among obese individuals. DESIGN: Prospective observational cohort study. METHODS: The EQUAL study, a European Quality Study on treatment in advanced chronic kidney disease, is a multicenter prospective observational cohort study in six European countries...
February 16, 2018: Journal of Renal Nutrition
Rattan S Rashpa, Vikram K Mahajan, Pankaj Kumar, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Vikas Sharma
Background: Chronic kidney disease (CKD)-associated mucocutaneous manifestations significantly impair the quality of life but often remain understudied. They may also vary across regions, socioeconomic and nutritional status, and racial differences. Objectives: To study the patterns of mucocutaneous disorders and their prevalence in CKD patients irrespective of clinical stage or dialysis status. Materials and Methods: 122 (M:F = 77:45) patients aged 21‒85 (Mean ± SD = 57...
January 2018: Indian Dermatology Online Journal
Joanne Reid, Helen R Noble, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalantar-Zadeh, John Mallett, C McKeaveney, S Porter, David S Seres, Joanne Shields, Adrian Slee, Miles D Witham, Alexander P Maxwell
BACKGROUND: Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD...
February 13, 2018: BMC Nephrology
Pasquale Esposito, Edoardo La Porta, Maria Antonietta Grignano, Daniela Verzola, Samantha Milanesi, Francesca Ansaldo, Marilena Gregorini, Carmelo Libetta, Giacomo Garibotto, Teresa Rampino
OBJECTIVE: Toll-like receptor 4 (TLR4) promotes inflammation in hemodialysis patients (HD). A soluble form of extracellular TLR4 (sTLR4) has been recently characterized, which showed the ability to attenuate TLR4 signalling. In this study, we describe the sTLR4 profile in regular HD patients. SUBJECTS: In a cross-sectional study we enrolled forty prevalent HD patients (68.2 ± 16.3 years, twenty-five males) with a median dialysis vintage of 41 months. Nineteen patients were undergoing standard bicarbonate HD (BHD) and 21 patients on-line hemodiafiltration (HDF)...
February 8, 2018: Journal of Renal Nutrition
D Jagadeswaran, E Indhumathi, A J Hemamalini, V Sivakumar, P Soundararajan, M Jayakumar
BACKGROUND: Malnutrition-inflammation complex syndrome (MICS), hyperhomocysteinemia, calcium and phosphate levels derangement have been predicted as important contributing factors for the progression of cardiovascular burden. Among patients with earlier stage of CKD, hypoalbuminaemia and inflammation deliberated as non-traditional cardiovascular risk factors, which add more burden to circulatory disease, mortality and rapid advancement to CKD stage 5. AIM: The aim of the study is to evaluate inflammation and nutritional status of CKD patients not on dialysis using Malnutrition inflammation score (MIS) and to verify the association with mortality in the follow-up period...
January 9, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Piergiorgio Bolasco, Stefano Murtas
This work is aimed for showing in detail to the nephrologists the methodology applied in the Combined Diet Dialysis Program (CDDP) in selected patients especially with the use of the Urea Nitrogen Appearance which allows to verify the sustainability and collaboration of patients on the 0.6 g/Kg/day hypoproteic diet by calculating the Protein Catabolic Rate in patients with metabolic steady state. It is also confirmed that the combined action of nutrition and the minimal contact with hemodialysis may allow a longer maintenance of the residual renal function with the further possibility of a greater excretion of Protein Bound Uremic Toxins and to obtain a phosphate balance thanks for a good maintenance of phosphaturia...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Piergiorgio Bolasco, Stefano Murtas
The purpose of this review is to give dignity at the Incremental Dialysis, which cannot be confused with the term and the therapeutic choice defined as Infrequent Dialysis. The Infrequent Dialysis is defined by each and every hemodialytic therapeutic choice like rhythms below thrice-weekly-hemodialytic treatments. Nonetheless, Infrequent Dialysis is a choice of replacement hemodialysis therapy with pays more special clinical attentions and nutritional monitoring and should also be accompanied by a slightly hypoproteic controlled nutrition...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Azrina Md Ralib, Mohd Basri Mat Nor
BACKGROUND AND OBJECTIVES: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). METHODS AND STUDY DESIGN: A prospective observational cohort study was conducted at the mixed medical- surgical of a tertiary ICU in Kuantan, Malaysia...
2018: Asia Pacific Journal of Clinical Nutrition
Jinhong Miao, Rui Liang, Ximei Tian, Xiaoyin Sun, Zhengyan Li, Jing Luo, Lan Ming, Juanjuan Shi
BACKGROUND AND OBJECTIVES: To investigate the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and the factors involved. METHODS AND STUDY DESIGN: We used the Subjective Global Assessment (SGA) of nutritional status, a general questionnaire, dietary records, and laboratory parameters from 3 consecutive days to develop a NS assessment with it, we assessed 240 patients undergoing CAPD at a dialysis center in Henan Province...
2018: Asia Pacific Journal of Clinical Nutrition
Pablo Molina, Belén Vizcaíno, Mariola D Molina, Sandra Beltrán, Mercedes González-Moya, Antonio Mora, Cristina Castro-Alonso, Julia Kanter, Ana I Ávila, José L Górriz, Nuria Estañ, Luis M Pallardó, Denis Fouque, Juan J Carrero
Background: Compared with conventional haemodialysis (HD), online haemodiafiltration (OL-HDF) achieves a more efficient removal of uraemic toxins and reduces inflammation, which could favourably affect nutritional status. We evaluate the effect of OL-HDF on body composition and nutritional status in prevalent high-flux HD (HF-HD) patients. Methods: In all, 33 adults with chronic kidney disease (CKD) Stage 5 undergoing maintenance HF-HD were assigned to post-dilution OL-HDF (n = 17) or to remain on HF-HD (n = 16, control group) for 12 months...
January 22, 2018: Nephrology, Dialysis, Transplantation
Manhua Zuo, Jun Tang, Miaomiao Xiang, Qing Long, Jianping Dai, Xiuying Hu
OBJECTIVES: Continuous renal replacement therapy (CRRT) is a specialized type of dialysis, however, the characteristics and associated factors of nosocomial pneumonia for undergoing CRRT patients was little attention until now. This study investigated the characteristics of and factors contributing to nosocomial pneumonia in patients receiving CRRT. METHODS: We retrospectively analyzed the clinical data of 1,160 cases from January 2008 to December 2015. Of these, 145 (12...
January 20, 2018: International Journal of Infectious Diseases: IJID
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