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nutritional status of patients with CKD

Chou-Yueh Chang, Horng-Rong Chang, Hsing-Chun Lin, Han-Hsin Chang
Objective Vegetarian diets have been shown to increase the risk of certain nutritional deficiencies, such as iron. As a number of patients with chronic kidney disease (CKD) in Taiwan are lacto-ovo vegetarians, the aim of this study was to investigate the effects of different proportions and sources of protein in lacto-ovo vegetarian and omnivorous diets, as well as the influence of adequate dietary protein intake, on renal function and nutritional status of Taiwanese patients with stage 3 to stage 5 CKD. Methods This is a cross-sectional study...
March 13, 2018: Journal of the American College of Nutrition
Nestoras Nicolas Mathioudakis, Estelle Everett, Shuvodra Routh, Peter J Pronovost, Hsin-Chieh Yeh, Sherita Hill Golden, Suchi Saria
Objective: To develop and validate a multivariable prediction model for insulin-associated hypoglycemia in non-critically ill hospitalized adults. Research design and methods: We collected pharmacologic, demographic, laboratory, and diagnostic data from 128 657 inpatient days in which at least 1 unit of subcutaneous insulin was administered in the absence of intravenous insulin, total parenteral nutrition, or insulin pump use (index days). These data were used to develop multivariable prediction models for biochemical and clinically significant hypoglycemia (blood glucose (BG) of ≤70 mg/dL and <54 mg/dL, respectively) occurring within 24 hours of the index day...
2018: BMJ Open Diabetes Research & Care
Verônica Torres da Costa E Silva, Elerson C Costalonga, Fernanda O Coelho, Renato A Caires, Emmanuel A Burdmann
Cancer patients are living longer. The sequelae of cancer treatment and the role of comorbid conditions present before the diagnosis, such as CKD, have been increasingly recognized. The interface between CKD and cancer is multifaceted. CKD is frequently observed in patients with cancer, and cancer treatment contributes to CKD development and progression. In addition, CKD has been recognized as an important risk factor for cancer development and reduced specific cancer survival. In this context, an accurate evaluation of the glomerular filtration rate (GFR) during oncologic treatment is pivotal and is used to define surgery strategies, program prophylactic management of contrasted examinations, make decisions on cisplatin eligibility, and adjust drug prescriptions, particularly chemotherapy agents...
January 2018: Advances in Chronic Kidney Disease
Carmine Zoccali, Francesca Mallamaci
Intention-to-treat and per-protocol analyses provide complementary information about the usefulness of therapies. While intention-to-treat analyses of trials that tested low-protein diets remain debated, per-protocol analyses of the same trials show that low protein intake actually reduces the risk of kidney failure. Per-protocol analyses are notoriously open to bias but intention-to-treat analyses are less immaculate than commonly realized because they critically depend on adherence to the treatment being tested and therefore may not be directly relevant for informing clinical decisions when different degrees of adherence to therapy occur...
February 19, 2018: Nephrology, Dialysis, Transplantation
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
Cheryl A M Anderson, Hoang Anh Nguyen
Diet counseling and nutrition education are recommended in the prevention and management of chronic kidney disease (CKD) and end-stage renal disease (ESRD). The importance of effectively addressing nutrition with patients has grown given the increasing prevalence of obesity, hypertension, and diabetes; conditions which influence CKD/ESRD. Dietary advice for individuals with CKD/ESRD can be seen as complex; and successful dietary management requires careful planning, periodic assessment of nutritional status, as well as monitoring of dietary compliance...
February 18, 2018: Seminars in Dialysis
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
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
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
Małgorzata Maraj, Beata Kuśnierz-Cabala, Paulina Dumnicka, Agnieszka Gala-Błądzińska, Katarzyna Gawlik, Dorota Pawlica-Gosiewska, Anna Ząbek-Adamska, Małgorzata Mazur-Laskowska, Piotr Ceranowicz, Marek Kuźniewski
Malnutrition-inflammation-atherosclerosis syndrome is one of the causes of increased mortality in chronic kidney disease (CKD). The aim of the study was to assess the inflammation and nutritional status of patients in end-stage kidney disease treated with maintenance hemodialysis. The study included a group of 98 hemodialyzed patients with stage 5 CKD (38 women and 60 men). Albumin, prealbumin (PRE), and C-reactive protein (CRP) were measured in serum samples collected before mid-week dialysis. Fruit and vegetables frequency intakes were assessed with a questionnaire...
January 11, 2018: Nutrients
Samantha Strickler, Rohit R Gupta, John T Doucette, Roopa Kohli-Seth
Background: In the USA, central line associated blood stream infections (CLABSIs) have been designated as 'never events', prompting initiatives towards a 'zero CLABSIs' standard. We propose that there are cascading risk factors predisposing certain patient cohorts to higher CLABSIs rates. Methods: A retrospective review of all CLABSI infections over a 12-month period was undertaken. Risk factors examined included catheter type, insertion site and parenteral nutrition (PN) status...
January 2018: Journal of Infection Prevention
Filipa Caeiro Alves, Jia Sun, Abdul Rashid Qureshi, Lu Dai, Sunna Snaedal, Peter Bárány, Olof Heimbürger, Bengt Lindholm, Peter Stenvinkel
BACKGROUND: The correlation of low serum albumin with mortality in patients with chronic kidney disease (CKD) is partly linked to its association with systemic inflammation. However, it is not clear to what extent albumin's correlation with mortality depends on concomitant systemic inflammation. Here we addressed this question in patients with CKD stage 5. METHODS: Serum albumin (S-Alb), systemic inflammation (high-sensitive C-reactive protein, hsCRP), cardiovascular disease (CVD) and nutritional status (subjective global assessment, SGA) were assessed at baseline in 822 patients: 523 incident dialysis patients, 212 prevalent hemodialysis (HD) and 87 prevalent peritoneal dialysis (PD) patients...
2018: PloS One
Almudena Pérez Torres, María Elena González García, Ana María López Sobaler, Rafael Jesús Sánchez Villanueva, Rafael Selgas Gutiérrez
BACKGROUND: Diet is one of the pillars of the treatment for patients with chronic kidney disease without dialysis (NDD-CKD). Despite this, very few studies have evaluated the diet in Spanish population. OBJECTIVE: To evaluate the diet of a group of patients with advanced CKD, comparing it with the recommendations, and its relation with nutritional status. MATERIAL AND METHODS: A cross-sectional study of 74 patients (39 men), with a mean age of 70...
October 27, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Elaine Ku, Joel D Kopple, Kirsten L Johansen, Charles E McCulloch, Alan S Go, Dawei Xie, Feng Lin, L Lee Hamm, Jiang He, John W Kusek, Sankar D Navaneethan, Ana C Ricardo, Hernan Rincon-Choles, Miroslaw Smogorzewski, Chi-Yuan Hsu
BACKGROUND: Few studies have investigated the changes in weight that may occur over time among adults with the progression of chronic kidney disease (CKD). Whether such weight changes are independently associated with death after the onset of end-stage renal disease has also not been rigorously examined. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: We studied 3,933 participants of the Chronic Renal Insufficiency Cohort (CRIC) Study, a longitudinal cohort of patients with CKD...
December 4, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Lu Dai, Hideyuki Mukai, Bengt Lindholm, Olof Heimbürger, Peter Barany, Peter Stenvinkel, Abdul Rashid Qureshi
BACKGROUND: The value of subjective global assessment (SGA) as nutritional assessor of protein-energy wasting (PEWSGA) in chronic kidney disease (CKD) patients depends on its mortality predictive capacity. We investigated associations of PEWSGA with markers of nutritional status and all-cause mortality in CKD patients. METHODS: In 1031 (732 CKD1-5 non-dialysis and 299 dialysis) patients, SGA and body (BMI), lean (LBMI) and fat (FBMI) body mass indices, % handgrip strength (% HGS), serum albumin, and high sensitivity C-reactive protein (hsCRP) were examined at baseline...
2017: PloS One
Giuseppe Agapito, Mariadelina Simeoni, Barbara Calabrese, Ilaria Caré, Theodora Lamprinoudi, Pietro H Guzzi, Arturo Pujia, Giorgio Fuiano, Mario Cannataro
BACKGROUND AND OBJECTIVE: Use of mobile and web-based applications for diet and weight management is currently increasing. However, the impact of known apps on clinical outcomes is not well-characterized so far. Moreover, availability of food recommender systems providing high quality nutritional advices to both healthy and diet-related chronic diseases users is very limited. In addition, the potentiality of nutraceutical properties of typical regional foods for improving app utility has not been exerted to this end...
January 2018: Computer Methods and Programs in Biomedicine
Alice Monzani, Michela Perrone, Flavia Prodam, Stefania Moia, Giulia Genoni, Sara Testa, Fabio Paglialonga, Anna Rapa, Gianni Bona, Giovanni Montini, Alberto Edefonti
BACKGROUND: Impairment in orexigenic/anorexigenic hormone balance may be key in the pathogenesis of protein energy wasting in children with chronic kidney disease (CKD). Measurement of ghrelin and obestatin concentrations in children with CKD would help assess the potential contribution of these hormones to uremic protein energy wasting. METHODS: This was a cross-sectional case-control study. Acylated and unacylated ghrelin and obestatin were measured in 42 children on conservative treatment (CT), 20 children on hemodialysis, 48 pediatric renal transplant (RTx) recipients and 43 controls (CTR) (mean age 11...
November 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
I-Ching Kuo, Jiun-Chi Huang, Pei-Yu Wu, Szu-Chia Chen, Jer-Ming Chang, Hung-Chun Chen
Evaluating nutritional status is crucial to detecting malnutrition in patients with chronic kidney disease (CKD). The Geriatric Nutritional Risk Index (GNRI) has been associated with overall and cardiovascular mortality in the dialysis population. The aim of this study was to evaluate whether the GNRI is associated with progression to dialysis in patients with moderate to advanced CKD. We enrolled 496 patients with stage 3-5 CKD who had received echocardiographic examinations, and categorized them according to baseline GNRI values calculated using the serum albumin level and body weight...
November 9, 2017: Nutrients
Ana C Ricardo, Vivien Goh, Jinsong Chen, Esteban Cedillo-Couvert, Mary Kapella, Bharati Prasad, Sharmila Parvathaneni, Kristen Knutson, James P Lash
INTRODUCTION: In general populations, short and long sleep duration, poor sleep quality and sleep disorders have been associated with increased risk of death. We evaluated these associations in individuals with chronic kidney disease (CKD). METHODS: Prospective cohort study of 1,452 National Health and Nutrition Examination Survey (NHANES) 2005-2008 participants with CKD. CKD was defined by estimated glomerular filtration rate <60 ml/min/1.73m(2) or urine albumin-to-creatinine ratio ≥30 mg/g...
September 2017: KI Reports
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