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Protein energy wasting hemodialysis

Rong-Shao Tan, Dan-Hua Liang, Yan Liu, Xiao-Shi Zhong, Dong-Sheng Zhang, Jing Ma
OBJECTIVE(S): To explore the validity of using bioelectrical impedance analysis (BIA)-derived 50 kHz phase angle (PhA) in predicting protein-energy wasting (PEW) in Chinese maintenance hemodialysis (MHD) patients. DESIGN AND METHODS: The design was a cross-sectional study. A total of 173 of MHD patients and 173 healthy adults were enrolled in the study. The prevalence of PEW in patients was performed by the International Society of Renal Nutrition and Metabolism criteria...
November 13, 2018: Journal of Renal Nutrition
F X Su, J Wu, C M Zhou, Q Li, S S Hu, X Lin, J J Da, Y Zha
Objective: To examine the relationship between low serum parathyroid hormone (PTH) and protein-energy wasting (PEW) in patients who underwent maintenance hemodialysis (MHD) treatment. Methods: A cross-sectional study was conducted in MHD patients between June 2015 and August 2017 in 11 MHD centers from Guizhou province. Body composition and physical parameters were measured, clinical data and other related laboratory values were collected according to the medical record system. Participants were assigned to low serum PTH group (PTH<150 ng/L), target PTH group (150 ng/L≤ PTH ≤300 ng/L) and high serum PTH group (PTH>300 ng/L)...
November 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Y Zha, F Sun
No abstract text is available yet for this article.
November 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Anaïs Bouchara, Dan Yi, Myriam Pastural, Samuel Granjon, Jean-Christophe Selag, Maurice Laville, Walid Arkouche, Solenne Pelletier, Denis Fouque, Christophe O Soulage, Laetitia Koppe
Wasting has been associated with increased cardiovascular and all-cause mortality in chronic kidney disease (CKD). We investigated whether serum zinc-alpha2-glycoprotein (ZAG), a potent cachectic and lipid-mobilizing factor that is increased in patients with CKD, predicts clinical outcomes in patients on chronic hemodialysis. We quantified serum ZAG at baseline in a prospective cohort of 252 patients undergoing maintenance hemodialysis. Serum ZAG concentrations were inversely associated with serum albumin, creatinine, and triglycerides and, conversely, positively associated with age...
November 2018: Kidney International
Carola-Ellen Kleine, Hamid Moradi, Elani Streja, Kamyar Kalantar-Zadeh
Obesity is a major risk factor for cardiovascular disease and worse survival in the general population. However, in patients with end-stage renal disease (ESRD), higher body mass index and indexes of body fat and muscle are associated with better survival. Furthermore, these associations, which some have described as the obesity paradox, are more consistent in African American patients being treated with hemodialysis when compared with other racial-ethnic groups. This is in view of data indicating that although the rate of progression to ESRD is faster in African American patients, they have a survival advantage after transition to ESRD when compared with their white counterparts...
November 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Stefano Murtas, Roberto Aquilani, Maria Luisa Deiana, Paolo Iadarola, Romina Secci, Mariella Cadeddu, Stefano Salis, Doriana Serpi, Piergiorgio Bolasco
OBJECTIVE: The objective of the study was to quantify the loss of total amino acids (TAAs), nonessential amino acids, essential amino acids, and branched chain amino acids (BCAAs) produced by high-efficiency hemodialysis (HEHD), postdilution hemodiafiltration (HDFpost), and predilution hemodiafiltration (HDFpre) using high ultrafiltration volumes; and to define the specific AA losses registered in HEHD, HDFpost, and HDFpre; to identify a potential metabolic and nutritional decline into protein energy wasting; to compare AA analysis of arterial blood samples taken from healthy controls and patients with end-stage renal disease undergoing hemodialysis...
October 16, 2018: Journal of Renal Nutrition
Sylwia Małgorzewicz, Grażyna Gałęzowska, Monika Cieszyńska-Semenowicz, Joanna Ratajczyk, Lidia Wolska, Przemysław Rutkowski, Magdalena Jankowska, Bolesław Rutkowski, Alicja Dębska-Ślizień
OBJECTIVES: Protein-energy wasting (PEW) is highly prevalent in patients on hemodialysis (HD). Oral nutritional supplementation (ONS) is recommended for malnourished patients on HD. The aim of this study was to evaluate ONS on plasma amino acid in HD patients with PEW. METHODS: Thirty-two HD patients with a mean age 59.1 ± 9.5 y with PEW were enrolled into the study. Patients were prescribed ONS (125 mL twice a day for 3 mo) together with dietary advice. The nutritional status was evaluated by means of body mass index, Subjective Global Assessment, and serum albumin and prealbumin levels...
July 11, 2018: Nutrition
Mun Sun Choi, Brandon Kistler, Gretchen N Wiese, Elizabeth R Stremke, Amy J Wright, Ranjani N Moorthi, Sharon M Moe, Kathleen M Hill Gallant
OBJECTIVE: Patients undergoing hemodialysis (HD) have high protein and energy requirements, and protein-energy wasting is common and associated with poor outcomes. Eating during dialysis may improve nutritional status by counteracting the catabolic effects of HD treatment; but eating during HD may be discouraged because of concerns of postprandial hypotension. However, little data are available to support this practice. In this study, we hypothesized that high-protein meals during HD do not lead to symptomatic intradialytic hypotension events...
August 11, 2018: Journal of Renal Nutrition
Richard A Ward, Werner Beck, Angelito A Bernardo, Filipa C Alves, Peter Stenvinkel, Bengt Lindholm
Hemodiafiltration (HDF) increases the removal of middle-molecular-weight uremic toxins and may improve outcomes in patients with end-stage kidney disease (ESKD), but it requires complex equipment and comes with risks associated with infusion of large volumes of substitution solution. New high-flux hemodialysis membranes with improved diffusive permeability profiles do not have these limitations and offer an attractive alternative to HDF. However, both strategies are associated with increased albumin loss into the dialysate, raising concerns about the potential for decreased serum albumin concentrations that have been associated with poor outcomes in ESKD...
August 8, 2018: Nephrology, Dialysis, Transplantation
Kenichi Akiyama, Norio Hanafusa
According to the current status of chronic dialysis therapy in Japan 2016, the average age at the time of dialysis initiation is 68.57 years for males and 71.19 years for females, which has been rising continuously. Frailty is a geriatric syndrome that is frequently seen in the elderly. It is known that frailty among dialysis patients are more common than the general population of the same age, and that frailty is associated with life prognosis. As eGFR decreases, BMD decreases and fracture risk increase, and dialysis patients are at the highest risk of fracture in CKD patients...
2018: Clinical Calcium
Lea Katalinic, Branimir Krtalic, Bojan Jelakovic, Nikolina Basic-Jukic
BACKGROUND/AIMS: There is a growing body of evidence that the long-term hemodialysis (HD) treatment leads to disturbances of carnitine homeostasis but the results of L-carnitine supplementation in HD patients have been conflicting. In the present prospective study, we investigated the effectiveness of intravenous L-carnitine in mitigating dialysis-related protein-energy wasting (PEW) based on pre-treatment albumin levels. METHODS: Fifty patients (46% male, mean age 63±18...
2018: Kidney & Blood Pressure Research
David E St-Jules, David S Goldfarb, Collin J Popp, Mary Lou Pompeii, Scott E Liebman
Protein-energy wasting (PEW) is a major diet-related complication in hemodialysis (HD) patients. Nutrient-based dietary guidelines emphasize animal-based protein foods for preventing and managing PEW in HD patients. Although dietary protein intake is important for protein anabolism, other dietary factors contribute to PEW. In this article, we examine the diet-related etiologies of PEW in HD patients, and discuss how they may be affected differently by animal- and plant-based protein foods. In general, animal foods are superior sources of protein, but may contribute more to metabolic derangements that cause PEW...
July 15, 2018: Seminars in Dialysis
Gloria Antón-Pérez, Ángelo Santana-Del-Pino, Fernando Henríquez-Palop, Tania Monzón, Ana Y Sánchez, Francisco Valga, Adelaida Morales-Umpierrez, Cesar García-Cantón, Jose C Rodríguez-Pérez, Juan J Carrero
OBJECTIVE: To study whether the score proposed by the International Society of Renal Nutrition and Metabolism to define the protein energy wasting (PEW) syndrome has diagnostic validity in patients undergoing dialysis. DESIGN AND METHODS: Cross-sectional study including 468 prevalent hemodialysis patients from Canary Islands, Spain. Individual PEW syndrome criteria and the number of PEW syndrome categories were related to other objective markers of PEW using linear and logistic regression analyses: subjective global assessment, handgrip strength, bioimpedance-assessed body composition, and levels of high-sensitivity C-reactive protein...
July 5, 2018: Journal of Renal Nutrition
Menaka Sarav, Csaba Pal Kovesdy
No abstract text is available yet for this article.
October 8, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Alice Sabatino, Giovanni Piotti, Carmela Cosola, Ilaria Gandolfini, Jeroen P Kooman, Enrico Fiaccadori
Protein energy wasting (PEW) is a condition commonly occurring among patients with ESRD on hemodialysis. PEW is characterized by depletion of protein and energy stores and is caused by multiple factors related to chronic kidney disease, acute and chronic comorbidities and by renal replacement therapy itself. Anorexia is central in the pathogenesis of PEW; it is frequently observed in these patients whose protein and energy intakes are typically lower than guidelines recommendations. If untreated, PEW invariably leads to major complications, and may activate a vicious circle with further worsening of nutritional status...
June 17, 2018: Seminars in Dialysis
Alice Sabatino, Giuseppe Regolisti, Marco Delsante, Tommaso Di Motta, Chiara Cantarelli, Sarah Pioli, Giulia Grassi, Valentina Batini, Mariacristina Gregorini, Enrico Fiaccadori
BACKGROUND & AIMS: Protein-Energy Wasting (PEW) is a pathological condition of renal patients with advanced Chronic Kidney Disease characterized by a progressive reduction of energy and protein assets. Nutritional status assessment, especially for what concerns muscle mass, is essential for both the identification of patients at risk for the development of PEW, as well as monitoring the effects of nutritional interventions. Ultrasound methods are easily applicable at the bedside for quantitative assessment of skeletal muscle...
May 19, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Norio Hanafusa, Daigo Kamei, Misao Tsukada, Naoko Miwa, Mizuki Komatsu, Shunji Shiohira, Masayuki Okazaki, Ryota Watanabe, Hiroshi Kawaguchi, Ken Tsuchiya, Kosaku Nitta
The older dialysis population is growing, and malnutrition and wasting syndrome are great concerns in this population. The management of these syndromes includes appropriate nutritional intake and physical activity. However, whether management in the form of an increase in protein intake has a beneficial effect on muscle mass has not been demonstrated. In this study, we investigated an association between changes of normalized protein catabolic rate (nPCR), as a proxy for protein intake and percent creatinine generation rate (%CGR), as a proxy for muscle mass in patients receiving hemodialysis...
2018: Contributions to Nephrology
Ashraf Mohamed Abd El Basset Bakr, Bothina Mohamed Hasaneen, Dina AbdelRasoul Helal Bassiouni
OBJECTIVE: Muscle status assessment is crucial for diagnosis of protein energy wasting PEW/cachexia in chronic kidney disease (CKD) population. Hand grip strength (HGS) has been used in muscle power assessment in adult CKD. However, no data is available about its usefulness in children with CKD. Hence, we aimed to study the reliability of HGS in reflecting the muscle power and thus, nutritional status in children with CKD. DESIGN AND METHODS: In this Observational cross sectional study we enrolled 73 CKD children; 45 had end stage kidney disease (ESKD) on hemodialysis (HD) and 28 had CKD but not on dialysis yet...
July 2018: Journal of Renal Nutrition
Hirotaka Komaba, Masafumi Fukagawa
Protein-energy wasting (PEW), a syndrome involving adverse changes in nutrition and body composition, is a serious problem associated with morbidity and mortality in patients with end-stage renal disease (ESRD). The pathogenesis of PEW is multifactorial, and the underlying mechanisms are not fully understood. However, recent translational work has provided compelling evidence for a causal role of parathyroid hormone (PTH) in the pathogenesis of adipose tissue browning and increased energy expenditure, a critical component of PEW in ESRD...
June 2018: Therapeutic Apheresis and Dialysis
Marta Arias-Guillén, Eduardo Perez, Patricia Herrera, Bárbara Romano, Raquel Ojeda, Manel Vera, José Ríos, Néstor Fontseré, Francisco Maduell
OBJECTIVES: To evaluate whether body composition monitor (BCM) could be a practical instrument for nephrologists to assess nutritional status in patients on hemodialysis (HD) and whether it is more effective in identifying patients at highest risk of developing protein-energy wasting (PEW) alone or in combination with other tools currently used for that purpose. DESIGN: Observational cross-sectional study in 91 HD patients (60 ± 14 years, 70.3% male, 24 ± 4...
September 2018: Journal of Renal Nutrition
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