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Hemodialysis Renal Nutrition

Ye-Ping Jiang, Ying Shen, Xiao-Rong Liu
OBJECTIVE: To investigate the nutritional status of children on maintenance hemodialysis due to stage 5 chronic kidney disease (CKD) and the clinical significance of nutritional assessment indices. METHODS: A total of 21 children on maintenance hemodialysis due to stage 5 CKD were grouped according to body mass index. The nutritional status was assessed based on anthropometric parameters, biochemical parameters, inflammatory factors, residual renal function, indices of dialysis adequacy, and resting energy expenditure...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Bahar Gürlek Demirci, Siren Sezer, Emre Tutal, Turan Çolak, Saliha Uyanık, Mehmet Haberal
OBJECTIVES: In kidney transplant recipients, reduced muscle mass and hand-grip strength are associated with impaired nutritional status. Serum testosterone is highly associated with muscle strength in the general population. Here, we aimed to determine the associations among serum testosterone, hand-grip strength, and nutritional and inflammatory parameters, as well as graft function. MATERIALS AND METHODS: Our study included 144 stable male kidney transplant recipients from our renal transplant outpatient clinic...
March 2018: Experimental and Clinical Transplantation
Katarzyna Wyskida, Jarosław Wajda, Dariusz Klein, Joanna Witkowicz, Rafał Ficek, Sylwia Rotkegel, Urszula Spiechowicz-Zatoń, Joanna Kocemba-Dyczek, Jarosław Ciepał, Magdalena Olszanecka-Glinianowicz, Andrzej Więcek, Jerzy Chudek
BACKGROUND: Diet is a key factor that determines proper alignment of calcium-phosphate and nutritional status among hemodialysis (HD) patients. OBJECTIVES: To assess the nutrient intake in relation to long-term calcium-phosphate control in HD patients with end-stage renal failure. MATERIAL AND METHODS: The study included 107 patients (66 men, 41 women) from 10 dialysis centers in the Upper Silesia region of Poland. To analyze the diet composition during the previous year, a portion-sized version of the Diet History Questionnaire II (DHQ-II) from National Institutes of Health was used...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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
Piergiorgio Bolasco, Stefano Murtas
This work is aimed for showing in detail to the nephrologists the methodology applied in the Combined Diet Dialysis Program (CDDP) in selected patients especially with the use of the Urea Nitrogen Appearance which allows to verify the sustainability and collaboration of patients on the 0.6 g/Kg/day hypoproteic diet by calculating the Protein Catabolic Rate in patients with metabolic steady state. It is also confirmed that the combined action of nutrition and the minimal contact with hemodialysis may allow a longer maintenance of the residual renal function with the further possibility of a greater excretion of Protein Bound Uremic Toxins and to obtain a phosphate balance thanks for a good maintenance of phosphaturia...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Piergiorgio Bolasco, Stefano Murtas
The purpose of this review is to give dignity at the Incremental Dialysis, which cannot be confused with the term and the therapeutic choice defined as Infrequent Dialysis. The Infrequent Dialysis is defined by each and every hemodialytic therapeutic choice like rhythms below thrice-weekly-hemodialytic treatments. Nonetheless, Infrequent Dialysis is a choice of replacement hemodialysis therapy with pays more special clinical attentions and nutritional monitoring and should also be accompanied by a slightly hypoproteic controlled nutrition...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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
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
Brandon M Kistler, Debbie Benner, Jerrilynn D Burrowes, Katrina L Campbell, Denis Fouque, Giacomo Garibotto, Joel D Kopple, Csaba P Kovesdy, Connie M Rhee, Alison Steiber, Peter Stenvinkel, Pieter Ter Wee, Daniel Teta, Angela Y M Wang, Kamyar Kalantar-Zadeh
Poor nutritional status and protein-energy wasting are common among maintenance dialysis patients and associated with unfavorable outcomes. Providing foods, meal trays, snack boxes, and/or oral nutritional supplements during hemodialysis can improve nutritional status and might also reduce inflammation, enhance health-related quality of life, boost patient satisfaction, and improve survival. Potential challenges include postprandial hypotension and other hemodynamic instabilities, aspiration risk, gastrointestinal symptoms, hygiene issues, staff burden, reduced solute removal, and increased costs...
January 2018: Journal of Renal Nutrition
Annabelle N Chua, Bradley A Warady
Optimal care of the pediatric end-stage renal disease (ESRD) patient on chronic dialysis is complex and requires multidisciplinary care as well as patient/caregiver involvement. The dialysis team, along with the family and patient, should all play a role in choosing the dialysis modality which best meets the patient's needs, taking into account special considerations and management issues that may be particularly pertinent to children who receive peritoneal dialysis or hemodialysis. Meticulous attention to dialysis adequacy in terms of solute and fluid removal, as well as to a variety of clinical manifestations of ESRD, including anemia, growth and nutrition, chronic kidney disease-mineral bone disorder, cardiovascular health, and neurocognitive development, is essential...
November 2017: Advances in Chronic Kidney Disease
Debbie Benner, Steven M Brunelli, Becky Brosch, Jane Wheeler, Allen R Nissenson
OBJECTIVE: Protein-energy wasting is common in end-stage renal disease patients undergoing dialysis and is strongly associated with mortality and adverse outcomes. Intradialytic oral nutritional supplements (ONS) reduce risk of mortality in these patients. Large studies characterizing the impact of ONS on other outcomes are lacking. We assessed the associations between administration of ONS and clinical and nutritional outcomes. DESIGN: Retrospective evaluation of a pilot program providing ONS to patients at a large dialysis organization in the United States...
December 6, 2017: Journal of Renal Nutrition
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
Mengli Tong, Yuhui Wang, Jun Ni, Ning Weng, Chuanxia Chen, Hongyu Chen, Lindholm Bengt
BACKGROUND: Peritoneal dialysis (PD) is well-established as renal replacement therapy in end stage renal disease and has survival rates similar or better than hemodialysis (HD) for the initial years on dialysis therapy. However retention rate is lower due to higher technique failure rates than in HD and few patients stay on PD for more than 10 years (PD>10 yrs ). Here we investigated clinical features characterizing PD>10 yrs patients. PATIENTS AND METHODS: In a single center study of 450 prevalent PD patients, 35 PD>10 yrs patients (n=35) were compared with patients (n=415) who had been on PD for shorter periods of time in terms of clinical characteristics...
2017: American Journal of Clinical and Experimental Urology
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
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3-) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
Renhua Lu, Carla Estremadoyro, Xiaohuan Chen, Mingli Zhu, Leonardo C Ribeiro, Yucheng Yan, Alessandra Brendolan, Wei Fang, Carlo Crepaldi, Zhaohui Ni, Leyi Gu, Claudio Ronco
INTRODUCTION: Given that it is difficult to randomize end-stage renal disease (ESRD) patients to either hemodialysis (HD) or peritoneal dialysis (PD), differences between these renal replacement therapy (RRT) modalities are of major interest and remain controversial. METHODS: All data on maintenance dialysis patients during 2009 to 2013 in the Renji Hospital in Shanghai, China and in the San Bortolo Hospital in Vicenza, Italy were selected. Patients who changed their therapy from HD to PD or PD to HD during this study were excluded...
November 8, 2017: International Journal of Artificial Organs
Michael Zilles, Christoph Betz, Oliver Jung, Stefan Gauer, Renate Hammerstingl, Astrid Wächtershäuser, Thomas J Vogl, Helmut Geiger, Aida Asbe-Vollkopf, Rainer U Pliquett
OBJECTIVE: End-stage renal disease associates with catabolism and sarcopenia. Hypothetically, peroral supplemental nutrition over 6 months prevents catabolism in hemodialysis patients. DESIGN: Prospective randomized pilot study ( Identifier: NCT00687050). SUBJECTS: Twenty-three hemodialysis patients (15 males and 7 females) with or without human immunodeficiency virus (HIV) infection of 2 ambulatory hemodialysis centers...
November 14, 2017: Journal of Renal Nutrition
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
Alessio Molfino, Gerald J Beck, Minwei Li, Joan C Lo, George A Kaysen
AIM: Correction of metabolic acidosis in patients with chronic kidney disease has been associated with improvement in thyroid function. We examined whether changes in bicarbonate were associated with changes in thyroid function in patients with end-stage renal disease receiving conventional or more frequent hemodialysis. METHODS: In the Frequent Hemodialysis Network Trials, the relationship between changes in serum bicarbonate, free triiodothyronine (FT3) and free thyroxine (FT4) was examined among 147 and 48 patients with endogenous thyroid function who received conventional (3x/week) or more frequent (6x/week) hemodialysis (Daily Trial) or who received conventional or more frequent nocturnal hemodialysis (Nocturnal Trial)...
October 24, 2017: Nephrology
Ji-Eun Lee, Jeong-Hoon Lim, Hye Min Jang, Yon Su Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Eugene Kwon, Hyun-Ji Kim, Jeung-Min Park, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Jang-Hee Cho, Yong-Lim Kim
BACKGROUND: The role of mineral metabolism in mortality among dialysis patients has received increased attention, but some aspects remain unclear. The aim of the present study was to investigate the prognostic value of serum calcium and phosphate levels for all-cause mortality and cause-specific mortality in dialysis patients. METHODS: Patients on hemodialysis and peritoneal dialysis were enrolled from a multicenter prospective cohort study in Korea (NCT00931970)...
2017: PloS One
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