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Nutrition esrd

Inkyong Hur, Yong Kyu Lee, Kamyar Kalantar-Zadeh, Yoshitsugu Obi
BACKGROUND: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemo-dialysis by individualizing the dose and frequency according to their RKF levels...
December 11, 2018: Cardiorenal Medicine
Sanjay Basu, John S Yudkin, Seth A Berkowitz, Mohammed Jawad, Christopher Millett
BACKGROUND: Type 2 diabetes mellitus and cardiovascular disease and have become leading causes of morbidity and mortality among Palestinian refugees in the Middle East, many of whom live in long-term settlements and receive grain-based food aid. The objective of this study was to estimate changes in type 2 diabetes and cardiovascular disease morbidity and mortality attributable to a transition from traditional food aid to either (i) a debit card restricted to food purchases, (ii) cash, or (iii) an alternative food parcel with less grain and more fruits and vegetables, each valued at $30/person/month...
November 2018: PLoS Medicine
Oleh M Akchurin
Chronic kidney disease is an ongoing deterioration of renal function that often progresses to end-stage renal disease. Management goals in children include slowing disease progression, prevention and treatment of complications, and optimizing growth, development, and quality of life. Nutritional management is critically important to achieve these goals. Control of blood pressure, proteinuria, and metabolic acidosis with dietary and pharmacologic measures may slow progression of chronic kidney disease. Although significant progress in management has been made, further research is required to resolve many outstanding controversies...
February 2019: Pediatric Clinics of North America
Jeroen P Kooman, Len A Usvyat, Marijke J E Dekker, Dugan W Maddux, Jochen G Raimann, Frank M van der Sande, Xiaoling Ye, Yuedong Wang, Peter Kotanko
Patients with end-stage renal disease (ESRD) experience unique patterns in their lifetime, such as the start of dialysis and renal transplantation. In addition, there is also an intricate link between ESRD and biological time patterns. In terms of cyclic patterns, the circadian blood pressure (BP) rhythm can be flattened, contributing to allostatic load, whereas the circadian temperature rhythm is related to the decline in BP during hemodialysis (HD). Seasonal variations in BP and interdialytic-weight gain have been observed in ESRD patients in addition to a profound relative increase in mortality during the winter period...
November 16, 2018: Blood Purification
Joy V Nolte Fong, Linda W Moore
Many physiological properties of the renal system influence nutrient metabolism, elimination, and homeostasis. Kidney failure poses significant challenges to maintaining adequate nutrition, most of which transplantation ameliorates. Comprehensive recommendations for managing nutritional derangements for patients with chronic kidney disease and end stage renal disease exist; however, there are only sparse guidelines for post-transplant malnutrition and adverse outcomes. Not only are guidelines limited, but little is known about dietary trends of post-kidney transplant recipients...
2018: Frontiers in Medicine
Bingjuan Yan, Xiaole Su, Boyang Xu, Xi Qiao, Lihua Wang
BACKGROUND: Dietary protein restriction has long been thought to play an important role in the progression of chronic kidney disease (CKD); however, the effect of dietary protein on the rate of decline in kidney function remains controversial. OBJECTIVE: We undertook a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the influence of protein restriction on chronic kidney disease. METHOD: Ovid MEDLINE (from 1946 to March 5, 2016), EMBASE (from 1966 to March 5, 2016), and the Cochrane Library (Inception to March 5, 2016) were searched to identify RCTs comparing different levels of protein intake for at least 24 weeks in adult patients with CKD...
2018: PloS One
O O Okunola, C O Erohubie, F A Arogundade, A A Sanusi, E I Unuigbe, O O Oyebisi, M A Adelaja, A Akinsola
BACKGROUND: Malnutrition is a common problem in chronic kidney disease contributing to adverse outcomes in terms of morbidity and mortality and overall poor quality of life. In our environment and indeed most other developing countries, the prevalence of malnutrition in the general population is high. The high cost and dearth of renal replacement therapy in developing countries underscores the need for identification of factors that if adequately addressed will lead to slowing down of the progression to End Stage Renal Disease...
September 2018: West African Journal of Medicine
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
Marisa Danielle Juarez
Children with end-stage renal disease (ESRD) on hemodialysis are at increased risk for malnutrition. Aggressive nutrition intervention such as intradialytic parenteral nutrition (IDPN) should be considered to prevent further co-morbidities and mortality associated with malnutrition when other interventions fail. IDPN is a non-invasive method of providing nutrition to malnourished hemodialysis (HD) patients via the HD access throughout the HD treatment. Although the evidence on the long-term benefits of IDPN is scant in pediatrics, there is evidence that it improves metabolic parameters and nutritional status...
2018: Frontiers in Pediatrics
Byoung-Geun Han, Jun Young Lee, Jae-Seok Kim, Jae-Won Yang
BACKGROUND: Fluid overload and protein-energy wasting (PEW) are common in patients with end-stage renal disease (ESRD) and lead to a poor prognosis. We aimed to evaluate the volume and nutritional status of ESRD patients and to determine the clinical significance of phase angle (PhA). METHODS: This study was a cross-sectional comparison of bioimpedance spectroscopy (BIS) findings in patients with non-dialysis chronic kidney disease (CKD) stage 5 (CKD5-ND, N = 80) and age/sex-matched peritoneal dialysis patients (PD, N = 80)...
September 19, 2018: Nutrients
María Del Mar Sánchez-Fernández, Gustavo A Reyes Del Paso, José Manuel Gil-Cunquero, María José Fernández-Serrano
OBJECTIVE: There is evidence of cognitive impairment in patients with end-stage renal disease in hemodialysis (ESRD-HD). However, few studies have exhaustively analyzed executive functions (EFs) in this population, especially considering the influence of a wide range of clinical variables. This study analyzes performance in different EF components in ESRD-HD patients compared to a group of healthy controls (HCs), in addition to the acute effects of HD and the associations of cognitive performance with clinical variables...
2018: PloS One
Sahir Kalim
PURPOSE OF REVIEW: Protein carbamylation is a posttranslational protein modification caused, in part, by exposure to urea's dissociation product cyanate. Additional modulators of protein carbamylation include circulating free amino acid levels, inflammation, diet, smoking, and environmental pollution exposures. Carbamylation reactions can modify protein charge, structure, and function, leading to adverse molecular and cellular responses. These changes have been linked to several pathologic biochemical pathways relevant to patients with end stage renal disease (ESRD) such as accelerated atherosclerosis and dysfunctional erythropoiesis, among others...
November 2018: Current Opinion in Nephrology and Hypertension
Jun Young Lee, Jae-Seok Kim, Jae-Won Yang, Seung Ok Choi, Joon Hyung Sohn, Byoung-Geun Han
OBJECTIVE: Malnutrition is very complex in patients with end-stage renal disease (ESRD) and is associated with poor prognosis. This is because hemodynamic changes, hormonal changes, persistent inflammatory reactions, and fluid overloads are more complicated as uremia is worsening. Bio-impedance spectroscopy (BIS) is a useful method to estimate fluid balance (Overhydration/ extracellular water, OH/ECW) and nutritional status (Phase angle, PhA). We aimed to evaluate the volume and nutritional status by BIS and to investigate the relationship between the appetite regulating hormones and the parameters of BIS in patients with stage 5 chronic kidney disease not undergoing dialysis (CKD5-ND)...
2018: PloS One
Guobin Su, Zhuangzhu Liu, Xindong Qin, Xu Hong, Xusheng Liu, Zehuai Wen, Bengt Lindholm, Juan-Jesus Carrero, David W Johnson, Nele Brusselaers, Cecilia Stålsby Lundborg
Background: Infections are common and can be fatal in patients undergoing long-term dialysis. Recent studies have shown conflicting evidence associating infection with vitamin D status or use of vitamin D and have not been systematically reviewed in this population. Methods: We searched PubMed, Web of Science, Cochrane Library, Embase and three Chinese databases from inception until December 2017 for interventional [non-randomized or randomized controlled trials (RCTs)], cohort and case-control studies on levels of serum 25-hydroxyvitamin D [25(OH)D] or use of vitamin D [supplemental nutritional vitamin D or vitamin D receptor activator (VDRA)] and infection (any infection, infection-required hospitalization or infection-related death or composite) in long-term dialysis patients...
July 27, 2018: Nephrology, Dialysis, Transplantation
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
Kavitha Anbarasu, Vinod Kumar Verma, Syed Sultan Beevi, Velagala Satti Reddy
This study intends to assess the impact of environmental factors on the onset of hypertension-induced end-stage renal disease (ESRD) and to compare the level of oxidative stress with nonhypertensive diabetic ESRD. ESRD patients were evaluated along with healthy controls through questionnaire for demographic, nutritional and lifestyle variables. Oxidants were measured along with antioxidants. Multiple linear regression (MLR) models were applied to analyze association of studied variables with oxidants and antioxidants...
October 2018: International Journal of Environmental Health Research
Łukasz Rogowski, Mariusz Kusztal, Tomasz Gołębiowski, Katarzyna Bulińska, Agnieszka Zembroń-Łacny, Joanna Wyka, Marian Klinger, Marek Woźniewski, Wioletta Dziubek
BACKGROUND: Patient malnutrition is a significant problem in the process of rehabilitation and treatment. One of the tools that can reveal the risk of malnutrition is a series of standardized nutritional questionnaires. OBJECTIVES: The aim of the study was to assess the nutritional status of patients with end-stage renal disease (ESRD) by means of the minimal nutritional assessment (MNA) scale. MATERIAL AND METHODS: The study group included respondents suffering from ESRD who were patients of the Dialysis Center at the Clinic of Nephrology and Transplantation Medicine at the University Clinical Hospital in Wrocław...
August 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Chi-Young Choi, Nam-Jun Cho, Samel Park, Hyo Wook Gil, Yun-Sook Kim, Eun Young Lee
RATIONALE: Currently, 15% of women in fertility age are infertile and the frequency is increasing. Among the various causes of infertility, end-stage renal disease (ESRD) has been shown to decrease the frequency of pregnancies compared with normal females. However, dialysis of patients with ESRD increases the likelihood of pregnancy.Herein, we report successful pregnancy and delivery after peritoneal dialysis in a patient who was misdiagnosed as primary infertility. PATIENT CONCERNS: A 37-year-old female who was unaware of her ESRD was misdiagnosed with primary infertility...
June 2018: Medicine (Baltimore)
Hideyuki Mukai, Hilda Villafuerte, Abdul Rashid Qureshi, Bengt Lindholm, Peter Stenvinkel
Low serum albumin (S-Alb) is a frequent feature of end-stage renal disease (ESRD) that independently predicts mortality. Serum albumin has mainly been considered a biomarker of visceral protein and immunocompetence status, fundamental to nutritional assessment. However, low S-albumin level is associated with persistent systemic inflammation and many bodies of evidence show that S-Alb has a limited role as a marker of nutritional status. We reported that a low S-Alb concentration was an independent risk factor for poor outcome in ESRD only in the presence of systemic inflammation...
September 2018: Seminars in Dialysis
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
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