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Nutrition hemodialysis

Clare B Jones, Christopher T Chan
Since the inception of hemodialysis (HD) for patients with chronic kidney disease, the "perfect" dialysis prescription has remained elusive. Part of this may relate to the heterogeneity among populations, individual patients, and differences in access to health provision. The optimal balance between dialysis frequency and duration to achieve reductions in patient morbidity and mortality continues to be debated. The concept of dialysis adequacy originated from a post hoc mathematical analysis of the National Cooperative Study and has evolved to become a way of calculating dialysis dose and standardizing the dialysis prescription...
August 9, 2018: Seminars in Dialysis
Shunsuke Yamada, Masanori Tokumoto, Masatomo Taniguchi, Hisako Yoshida, Hokuto Arase, Narihito Tatsumoto, Hideki Hirakata, Takanari Kitazono, Kazuhiko Tsuruya
The use of phosphate (P)-binders allows hemodialysis patients to take in more protein and thus may maintain a good nutritional status. Protein-energy-malnutrition increases the risk of infection-related death. The association between use of P-binders and the relative risks of infection-related death remains unknown in hemodialysis patients. A total of 2926 hemodialysis patients registered to the Q-Cohort Study was followed up for 4-years. The association between use of P-binders and the risks for infection-related and all-cause mortality were estimated by Cox proportional hazards risk model with multiple adjustments by conventional and propensity-score based approaches...
July 30, 2018: Scientific Reports
Norifumi Harimoto, Hiroki Hoshino, Ryo Muranushi, Kei Hagiwara, Takahiro Yamanaka, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Kenichirou Araki, Ken Shirabe
BACKGROUND/AIM: Recently, skeletal muscle quality was important in patients with malignant tumors to predict the surgical outcome. The relationship between postoperative complications of Clavien-Dindo grade III or more and prognosis in patients who have undergone hepatic resection for hepatic malignancies were investigated. PATIENTS AND METHODS: Patient data were retrospectively collected for 146 consecutive patients who underwent curative hepatic resection in the Department of Hepatobiliary and Pancreatic Surgery, Gunma University, Japan, for hepatic malignancy...
August 2018: Anticancer Research
Norio Imai, Minako Wakasugi, Naoto Endo
Intervention of the osteoporosis liaison service for hemodialysis patients is considered essential, because hemodialysis patients are at higher risk of fracture and fall than individuals not undergoing dialysis. It may help to maintain the activity of hemodialysis patients to practice interprofessional collaboration for consistent prevention of primary fracture, thereby supporting discharge planning. We expect to organize a specialized fracture prevention team for dialysis patients to manage their anti-osteoporosis medication and nutritive support, as well as to evaluate their physical statuses and prevent falls...
2018: Clinical Calcium
Marta Cholewa, Katarzyna Madziarska, Malgorzata Radwan-Oczko
OBJECTIVES: To analyze the association between periodontal conditions and inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis (HD) patients. MATERIAL AND METHODS: We analyzed 128 HD patients divided into two groups: dentate (n = 103) and edentulous (n=25). The following items were assessed: baseline characteristics, age at the start and duration of HD, biochemical data: C-reactive protein (CRP), serum albumin, calcium, phosphorus, alkaline phosphatase, parathormone...
July 23, 2018: Journal of Applied Oral Science: Revista FOB
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...
July 17, 2018: Kidney & Blood Pressure Research
Crina Claudia Rusu, Simona Racasan, Diana Moldovan, Alina Potra, Dacian Tirinescu, Cristian Budurea, Remus Orasan, Ioan Mihai Patiu, Cosmina Bondor, Dan Vladutiu, Dan Delean, Alexandra Danu, Ina Maria Kacso
PURPOSE: Exogenous ghrelin is associated with cardiovascular protection in experimental and human studies. Nevertheless ESRD patients have increased ghrelin levels and severe cardiovascular comorbidities. This study aims to elucidate the metabolic factors influencing endogenous ghrelin/acyl ghrelin levels and to analyze the relation between endogenous ghrelin/acyl ghrelin levels and cardiac and vascular function markers in hemodialysis patients. METHODS: The cross-sectional study was conducted in hemodialysis patients (n = 88); 50 of them were men, mean age 61...
July 13, 2018: International Urology and Nephrology
Krzysztof Hoppe, Krzysztof Schwermer, Anna Kawka, Patrycja Klysz, Ewa Baum, Malgorzata Kaluzna, Dorota Sikorska, Anna Scigacz, Bengt Lindholm, Krzysztof Pawlaczyk, Andrzej Oko
Introduction: Body mass decomposition and hydration state imbalances affect patients on maintenance dialysis. We compared body composition, hydration and nutritional state of patients on peritoneal dialysis (PD) and hemodialysis (HD) based on dialysis vintage (DV). Material and methods: Three hundred and fifty-nine prevalent patients on HD ( n = 301) and PD ( n = 58) were divided into 3 subgroups depending on DV: < 2 years HD ( n = 41) and PD ( n = 28), 2-4 years HD ( n = 111) and PD ( n = 17), > 4 years HD ( n = 149) and PD ( n = 13)...
June 2018: Archives of Medical Science: AMS
Yucheng Yan, Mia Wang, Jarcy Zee, Doug Schaubel, Charlotte Tu, JiaQi Qian, Brian Bieber, Mei Wang, Nan Chen, Zuo Li, Friedrich K Port, Bruce M Robinson, Shuchi Anand
Introduction: In China, a quarter of patients are undergoing 2-times weekly hemodialysis. Using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS), we tested the hypothesis that whereas survival and hospitalizations would be similar in the presence of residual kidney function (RKF), patients without RKF would fare worse on 2-times weekly hemodialysis. Methods: In our cohort derived from 15 units randomly selected from each of 3 major cities (total N = 45), we generated a propensity score for the probability of dialysis frequency assignment, estimated a survival function by propensity score quintiles, and averaged stratum-specific survival functions to generate mean survival time...
July 2018: KI Reports
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Maria Rita Moio, Antioco Fois, Riccardo Cao, Ida Molfino, Ana Kaniassi, Francoise Lippi, Ludivine Froger, Antonello Pani, Marilisa Biolcati
BACKGROUND: Choice of dialysis is context sensitive, explored for PD and extracorporeal dialysis, but less studied for haemodialysis (HD) and hemodiafiltration (HDF), both widely employed in Italy and France; reasons of choice and differences in prescriptions may impact on dialysis-related variables, particularly relevant in elderly, high-comorbidity patients. METHODS: The study involved two high-comorbidity in-hospital cohorts, treated in Centers with similar characteristics, in Italy (Cagliari) and France (Le Mans)...
July 9, 2018: BMC Nephrology
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
Muhammad Nauman Hashmi, Hammad Raza, Wael Elshazly, Fayez Hejaili, Abdullah Al Sayyari
OBJECTIVE: To develop a simple, objective, cheap scoring tool incorporating nutritional parameters and other variables to predict hospitalization and mortality among hemodialysis patients - a tool that could be utilized in low resource countries. METHODS: The following variables were scored according to severity into 0, 1, 2 or 3: BMI, functional capacity, HD vintage in years, serum albumin, serum ferritin, and the number of comorbid conditions (diabetes mellitus, hypertension, ischemic heart disease, cerebrovascular disease)...
July 3, 2018: Blood Purification
Toshiyuki Nakao, Yoshie Kanazawa, Toshimasa Takahashi
BACKGROUND: For patients with end-stage renal failure (ESFR), thrice-weekly hemodialysis is a standard care. Once-weekly hemodialysis combined with low-protein and low-salt dietary treatment (OWHD-DT) have been rarely studied. Therefore, here, we describe our experience on OWHD-DT, and assess its long-term effectiveness. METHODS: We instituted OWHD-DT therapy in 112 highly motivated patients with creatinine clearance below 5.0 mL/min. They received once-weekly hemodialysis on a diet of 0...
June 28, 2018: BMC Nephrology
Soki Kurumisawa, Koji Kawahito
The prognostic nutritional index is an effective prognostic tool used in gastrointestinal surgeries. However, its value has not been verified in cardiovascular surgeries. This study aimed to investigate its utility in hemodialysis-dependent patients undergoing cardiac surgery. We retrospectively reviewed data of 110 hemodialysis-dependent patients who underwent cardiac surgery between January 2006 and July 2016. 20 variables were evaluated for short- and long-term mortality prediction. Patients were divided into high and low prognostic nutritional index groups with values > 34 (n = 90) and ≤ 34 (n = 20), respectively...
June 27, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Elina Eleftheria Pliakos, Nikolaos Andreatos, Panayiotis D Ziakas, Eleftherios Mylonakis
Background: Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of Central Line-Associated Bloodstream Infections (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI. Methods: We constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in three settings: hemodialysis, cancer treatment and home parenteral nutrition...
June 26, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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
Serpil Muge Deger, Jennifer R Hewlett, Jorge Gamboa, Charles D Ellis, Adriana M Hung, Edward D Siew, Cindy Mamnungu, Feng Sha, Aihua Bian, Thomas G Stewart, Naji N Abumrad, T Alp Ikizler
Maintenance hemodialysis (MHD) patients display significant nutritional abnormalities. Insulin is an anabolic hormone with direct effects on skeletal muscle (SM). We examined the anabolic actions of insulin, whole-body (WB) and SM protein turnover, in 33 MHD patients and 17 participants without kidney disease using hyperinsulinemic euglycemic euaminoacidemic (dual) clamp. Gluteal muscle biopsies were obtained before and after the dual-clamp. At baseline, WB protein synthesis and breakdown rates were similar in MHD patients...
June 12, 2018: American Journal of Physiology. Endocrinology and Metabolism
Hokuto Arase, Shunsuke Yamada, Ryusuke Yotsueda, Masatomo Taniguchi, Hisako Yoshida, Masanori Tokumoto, Toshiaki Nakano, Kazuhiko Tsuruya, Takanari Kitazono
BACKGROUND AND AIMS: The modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr levels, and Kt/V for urea, reflects skeletal muscle mass in patients on hemodialysis. Whether the modified Cr index is associated with cardiovascular events and all-cause mortality remains unknown. METHODS: A total of 3027 patients registered in the Q-Cohort Study, a multicenter, prospective study of patients on hemodialysis in Japan, were analyzed. The main outcomes were cardiovascular events and all-cause mortality...
June 2, 2018: Atherosclerosis
Yasushi Ohashi, Ken Sakai, Hiroki Hase, Nobuhiko Joki
Fluid volume overload is common and is associated with adverse outcomes in hemodialysis patients. Practicing physicians individually manage fluid volume balance in their dialysis patients according to blood pressure, interdialytic weight gain, cardiac function, nutritional status, and other comorbidities. However, accurate assessment of fluid volume status remains a concern. Indicators of dry weight target have been explored further with newer concepts and technologies. In general, total body water comprises approximately 50%-60% of adult body weight (range, 45%-75%), and water comprises 73...
June 6, 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
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