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malnutrition in esrd

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https://www.readbyqxmd.com/read/28910791/inflammation-and-protein-energy-wasting-in-the-uremic-milieu
#1
Magdalena Jankowska, Gabriela Cobo, Bengt Lindholm, Peter Stenvinkel
Inflammation is normally a protective and physiological response to harmful stimuli, but typically becomes an uncontrolled, maladaptive, and persistent process in patients with end-stage renal disease (ESRD). Through a deleterious cascade of poorly controlled reactions mediated by biologically active molecules (also called middle molecular weight uremia retention solutes), inflammation associates with a range of complications including cardiovascular disease and protein-energy wasting (PEW). Persistent inflammation, which is central to the conceptual etiological models of PEW and the malnutrition, inflammation, and atherosclerosis syndrome, induces and reignites processes leading to PEW in a number of ways including stimulation of both direct and indirect mechanisms of muscle proteolysis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28834362/is-high-volume-online-hemodiafiltration-associated-with-malnutrition
#2
Nicolás Macías, Almudena Vega, Soraya Abad, Alba Santos, Santiago Cedeño, Tania Linares, Ana María García-Prieto, Inés Aragoncillo, Claudia Yuste, Juan Manuel López-Gómez
Chronic malnutrition is a common problem in patients with end-stage renal disease on hemodialysis. Some studies have reported albumin loss into dialysis fluid during postdilution online hemodiafiltration (OL-HDF). The aim of the study was to assess the nutritional status of patients on high-volume OL-HDF and to demonstrate that higher convective clearances are not associated with malnutrition due to possible loss of nutrients with ultrafiltration. Demographic and clinical data, corporal composition with bioimpedance spectroscopy, dialysis features, albumin loss into dialysis fluid and laboratory parameters were collected in twenty-eight patients with ESRD undergoing postdilution OL-HDF with stable convective volumes over 28 L/session...
August 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28775001/characterization-and-correction-of-olfactory-deficits-in-kidney-disease
#3
Sagar U Nigwekar, Jeremy M Weiser, Sahir Kalim, Dihua Xu, Joshua L Wibecan, Sarah M Dougherty, Laurence Mercier-Lafond, Kristin M Corapi, Nwamaka D Eneanya, Eric H Holbrook, Dennis Brown, Ravi I Thadhani, Teodor G Păunescu
Patients with CKD suffer from food aversion, anorexia, and malnutrition. Although olfaction has a significant role in determining food flavor, our understanding of olfactory impairment and of the olfaction-nutrition axis in patients with kidney disease is limited. We quantified odor identification, odor threshold, and subjective odor perception in a cohort (n=161) comprising 36 participants with CKD, 100 participants with ESRD, and 25 controls. We investigated olfaction-nutrition associations in these participants and examined a novel intervention to improve olfaction in ESRD...
August 3, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28680376/dendritic-cell-dysfunction-in-patients-with-end-stage-renal-disease
#4
REVIEW
Ji Ung Kim, Miyeon Kim, Sinae Kim, Tam Thanh Nguyen, Eunhye Kim, Siyoung Lee, Soohyun Kim, Hyunwoo Kim
End-stage renal disease (ESRD) with immune disorder involves complex interactions between the innate and adaptive immune responses. ESRD is associated with various alterations in immune function such as a reduction in polymorphonuclear leukocyte bactericidal activity, a suppression of lymphocyte proliferative response to stimuli, and a malfunction of cell-mediated immunity at the molecular level. ESRD also increases patients' propensity for infections and malignancies as well as causing a diminished response to vaccination...
June 2017: Immune Network
https://www.readbyqxmd.com/read/28604513/severe-sarcopenia-and-increased-fat-stores-in-pediatric-patients-with-liver-kidney-or-intestine-failure
#5
Richard S Mangus, Weston J Bush, Chandrashekhar A Kubal, Christina Miller
OBJECTIVES: Malnutrition and wasting predict clinical outcomes in children with severe chronic illness. Objectively calculated malnutrition in children with end-stage organ failure has not been well studied. This analysis compares children with kidney, liver or intestine failure to healthy controls to quantitate the disparity in muscle and fat stores. METHODS: Children younger than age 19 with end stage liver, kidney or intestine failure and with pre-transplant computed tomography (CT) imaging were selected from the transplant database...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28420212/nutritional-status-predicts-10-year-mortality-in-patients-with-end-stage-renal-disease-on-hemodialysis
#6
Shin Sook Kang, Jai Won Chang, Yongsoon Park
Protein-energy wasting (PEW) is associated with mortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR), and malnutrition inflammation score (MIS), were measured at baseline...
April 18, 2017: Nutrients
https://www.readbyqxmd.com/read/28315744/cardiac-implantable-electronic-device-infections-who-is-at-greatest-risk
#7
Parijat Saurav Joy, Gagan Kumar, Jeanne E Poole, Barry London, Brian Olshansky
BACKGROUND: Cardiac implantable electronic device (CIED) infections are associated with hospitalization, mortality, increased costs, and adverse outcomes. OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities, and clinical characteristics over a 12-year period. METHODS: Utilizing data from the National Inpatient Sample database for cases from 2000 through 2012, we identified procedures for device-related infection (DRI) using International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) codes for CIED removal with diagnosis codes for device-related infection or systemic infection...
June 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28286773/the-strategy-to-prevent-and-regress-the-vascular-calcification-in-dialysis-patients
#8
REVIEW
Nai-Ching Chen, Chih-Yang Hsu, Chien-Liang Chen
The high prevalence of arterial calcification in end-stage renal disease (ESRD) is far beyond the explanation by common cardiovascular risk factors such as aging, diabetes, hypertension, and dyslipidemia. The finding relies on the fact that vascular and valvular calcifications are predictors of cardiovascular diseases and mortality in persons with chronic renal failure. In addition to traditional cardiovascular risk factors such as diabetes mellitus and blood pressure control, other ESRD-related risks such as phosphate retention, excess calcium, and prolonged dialysis time also contribute to the development of vascular calcification...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28264439/protein-nutrition-and-malnutrition-in-ckd-and-esrd
#9
REVIEW
Yan Zha, Qi Qian
Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, endothelin-1 and renin-angiotensin-aldosterone (RAAS) axis; anabolic hormone resistance; energy expenditure elevation; and uremic toxin accumulation. All of these derangements can further worsen kidney function, leading to poor patient outcomes...
February 27, 2017: Nutrients
https://www.readbyqxmd.com/read/28229311/prevalence-of-frailty-in-end-stage-renal-disease-a-systematic-review-and-meta-analysis
#10
REVIEW
Gotaro Kojima
PURPOSE: The purpose of this study is to perform a systematic review and meta-analysis on prevalence of frailty among patients with end-stage renal disease (ESRD). ESRD is associated with malnutrition, chronic inflammation, acidemia, impaired hormonal changes, and low physical activity, all of which can directly and indirectly contribute to the development of frailty. Coexistence of ESRD and frailty has been shown to increase risks of adverse health outcomes. Given potential reversibility of frailty, it is important to examine frailty status in this high-risk population...
February 22, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28161839/osteoprotegerin-and-uremic-osteoporosis-in-chronic-hemodialysis-patients
#11
Diana Moldovan, Crina Rusu, Alina Potra, Ioan Moldovan, Ioan Mihai Patiu, Mirela Gherman-Caprioara, Ina Maria Kacso
INTRODUCTION: Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HD patients. METHODS: This cross-sectional study has been realized on a cohort of 63 chronic HD patients. INCLUSION CRITERIA: elderly prevalent HD patients with an age over 55 years old...
May 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28078814/life-threatening-nutritional-deficiencies-in-a-dialysis-patient
#12
Fahad Aziz, Kunal Chaudhary
Nutritional deficiencies are very common among the patient on chronic hemodialysis. But they can be easily overlooked or misdiagnosed. Deficiencies of trace elements and phosphorous is rare among this patient population but if neglected can lead to catastrophic effects. We describe a case report of a patient with ESRD recently started on outpatient maintenance hemodialysis, who presented with life threatening muscular weakness with respiratory failure requiring prolonged mechanical ventilation. On initial workup, it was unclear what the cause of her weakness was, however, further investigations showed undetectable phosphorous levels as well as very low levels of trace elements...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28050464/senior-loken-syndrome
#13
Amarpreet Kaur, Shashi Kant Dhir, Geetika Goyal, Naveen Mittal, R K Goyal
Senior Loken Syndrome (SLS) is a rare genetic disorder having juvenile nephronophthisis and retinal degeneration progressing to blindness and end stage renal disease. The present case report is about two sisters who presented with decreased visual acuity and end stage renal disease. Both had decreased vision, pallor, deranged renal function test and chronic malnutrition. Investigations revealed anaemia, uraemia, raised creatinine, low Glomerular Filteration Rate (GFR). Ophthalmology examination revealed nystagmus, retinal examination depicted pale optic disc and pigmentary changes in the retina...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27904623/comparison-of-malnutrition-in-hemodialysis-and-peritoneal-dialysis-patients-and-its-relationship-with-echocardiographic-findings
#14
Afsoon Emami Naini, Alireza Karbalaie, Mokhtar Abedini, Gholamreza Askari, Firouzeh Moeinzadeh
BACKGROUND: Malnutrition is common in patients with end-stage renal disease (ESRD) who on peritoneal dialysis (PD) or hemodialysis (HD). This study aimed to compare the frequency distribution of malnutrition in HD and PD patients and its relationship with echocardiographic findings. MATERIALS AND METHODS: This is a case-control study. Using the simple random sampling, 109 patients were selected among HD and PD patients based on the inclusion criteria. HD and PD groups included 55 and 54 patients, respectively...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27900977/unconventional-strategies-in-the-battle-of-focal-and-segmental-glomerulosclerosis
#15
Satish Mendonca, R S V Kumar, Devika Gupta, Pooja Gupta, Satish Barki, M L Sharma
A 24-year-old male presented with classic features of the nephrotic syndrome. An initial renal biopsy revealed minimal change disease and thereafter, a second biopsy showed features of focal and segmental glomerulosclerosis. There was no response to conventional immunosuppression, and the patient had to be given rituximab; in spite of this, he went on to develop end-stage renal disease. He continued to have heavy proteinuria leading to severe hypoalbuminemia, thrombosis, infections, and malnutrition, placing the patient in a life-threatening situation...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#16
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
January 2017: New Microbiologica
https://www.readbyqxmd.com/read/27753805/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#17
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642932/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#18
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27619398/serum-albumin-and-von-willebrand-factor-possible-markers-for-early-detection-of-vascular-damage-in-children-undergoing-peritoneal-dialysis
#19
Nuran Cetın, Nadide M Sav, Duran Karabel, Ali Yildirim, Bilal Yıldız
PURPOSE: Cardiovascular diseases are the main causes of morbidity and mortality in children with end-stage renal disease and the relationships among several relevant potential biomarkers were investigated in pediatric peritoneal dialysis patients. METHODS: Serum homocysteine, von Willebrand factor (vWF), apolipoproteins A and B, lipoprotein-a, high sensitive-CRP, hemoglobin, phosphorus and parathyroid hormone (PTH) levels, systolic (SBP) and diastolic (DBP) blood pressure, carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured in 21 pediatric peritoneal dialysis patients and control subjects...
September 11, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27611091/underweight-is-an-independent-risk-factor-for-renal-function-deterioration-in-patients-with-iga-nephropathy
#20
Yan Ouyang, Jingyuan Xie, Meng Yang, Xiaoyan Zhang, Hong Ren, Weiming Wang, Nan Chen
Studies on the relationship between body mass index (BMI) and renal progression in IgA Nephropathy (IgAN) were limited, especially for underweight patients with IgAN. To elucidate the clinical features and effect of underweight on renal function deterioration in this disease, we recruited IgAN patients with diagnostic age ≥18 years old and a baseline estimated glomerular filtration rate (eGFR) ≥15 ml/min/1.73m2 from our center between 1985 and 2014. Patients secondary to systemic diseases or follow-up less than 6 months were excluded...
2016: PloS One
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