medigraphic.com
ISSN 0326-3428 (Print)
Órgano de difusión científica de la Asociación Nefrológica de Buenos Aires

2023, Number 2

<< Back Next >>

Rev Nefrol Dial Traspl 2023; 43 (2)

Longitudinal study of the body mass index and biochemical nutritional parameters of patients in dialysis

Gutiérrez BFJ, García PR, Fernández CR, Liñán GA

Language: English
References: 41
Page: 96-105
PDF size: 261.19 Kb.


ABSTRACT

Background/Aim: Chronic kidney failure is frequently related to malnutrition. This research aimed to assess the nutritional status of hemodialysis patients by assessing their biochemical and anthropometric parameters and determining whether the disorders suffered stemmed from nutritional deterioration directly related to time on dialysis. Materials and Methods: This research monitored 90 patients of both genders with chronic kidney failure who regularly received hemodialysis at the kidney unit of our Hospital in Granada (Spain) over five years. The patient’s blood was tested quarterly for plasma albumin (Alb), total cholesterol (TC), and total proteins (TP) and monthly for transferrin (Tr). Anthropometric measurements were taken of the patient’s weight, height, and body mass index (BMI) and, based on the patient’s BMI, classified as established by the World Health Organization. Results: During the five years of our study, patients experienced a statistically significant decrease in total protein (0.941g/dl), plasma albumin (0.9382g/dl), total cholesterol (23.77mg/dl), and transferrin (78.17. g/ dl) p ‹ 0.0001. On the contrary, the mean BMI values did not show statistically relevant differences (p ‹ 0.805). However, all patients remained in the WHO category of overweight. The body volume values did not show statistically significant differences either. Conclusions: In conclusion, the nutritional deterioration of these patients was not reflected in their BMI but mainly in their serum chemistry.


REFERENCES

  1. Ikizler T. A. Optimal nutrition in hemodialysis patients.Advances in Chronic Kidney Disease. 2013;20(2):181–189. doi: 10.1053/j.ackd.2012.12.002.

  2. Bigogno F. G., Fetter R. L., Avesani C. M.Applicability of subjective global assessment andmalnutrition inflammation score in the assessment ofnutritional status on chronic kidney disease. JornalBrasileiro de Nefrologia. 2014;36(2):236–240.

  3. Bramania PK, Ruggajo P, Bramania R, Mahmoud M,Furia FF. Prevalence of malnutrition inflammationcomplex syndrome among patients on maintenancehaemodialysis at Muhimbili National Hospital inTanzania: a cross-sectional study. BMC Nephrol.2020 Nov 30;21(1):521.

  4. Ruperto M., Sánchez-Muniz F. J., Barril G. Predictorsof protein-energy wasting in haemodialysis patients: across-sectional study. Journal of Human Nutrition andDietetics. 2016;29(1):38–47.

  5. Zafar R. A new insight into the pathogenesisof cardiovascular diseases: stress-induced lipidmediated,vascular diseases. Journal of CardiovascularDiseases and Diagnosis. 2015; 3:2–21.

  6. Liakopoulos V., Roumeliotis S., Gorny X., DounousiE., Mertens P. R. Oxidative stress in hemodialysispatients: a review of the literature. Oxidative Medicineand Cellular Longevity. 2017; 2017:22.

  7. Boudouris G., Verginadis I. I., Simos Y. V., et al. .Oxidative stress in patients treated with continuousambulatory peritoneal dialysis (CAPD) and thesignificant role of vitamin C and e supplementation.International Urology and Nephrology.2013;45(4):1137–1144.

  8. Said S., Hernandez G. T. The link between chronickidney disease and cardiovascular disease. Journal ofNephropathology. 2014;3(3):99–104.

  9. Brucki S. M. D., Nitrini R., Caramelli P., BertolucciP. H. F., Okamoto I. H. Suggestions for utilization ofthe mini-mental state examination in Brazil. Arquivosde Neuro-Psiquiatria. 2003;61(3B):777–781.

  10. Cano N. J. M., Miolane-Debouit M., Léger J., HengA. E. Assessment of body protein: energy status inchronic kidney disease. Seminars in Nephrology.2009;29(1):59–66.

  11. Lee J., Choi J. Y., Kwon Y. K., et al. . Changes inserum metabolites with the stage of chronic kidneydisease: comparison of diabetes and non-diabetes.Clinica Chimica Acta. 2016; 459:123–131.

  12. Morais A. A. C., Silva M. A. T., Faintuch J., et al.. Correlation of nutritional status and food intake inhemodialysis patients. Clinics. 2005;60(3):185–192.

  13. Fouque D, Kalantar-Zadeh K, Kopple J, CanoN, Chauveau P, Cuppari L, et al. . A proposednomenclature and diagnostic criteria for proteinenergywasting in acute and chronic kidney disease.Kidney Int. 2008;73(4):391-98.

  14. Hecking E, Bragg-Gresham JL, Rayner HC, PisoniRL, Andreucci VE, Combe C, et al. . Haemodialysisprescription, adherence, and nutritional indicatorsin five European countries: results from the DialysisOutcomes and Practice Patterns Study (DOPPS).Nephrol Dial Transplant. 2004;19(1):100-7.

  15. Combe C, McCullough KP, Asano Y, GinsbergN, Maroni BJ, Pifer TB. Kidney Disease OutcomesQuality Initiative (K/DOQI) and the DialysisOutcomes and Practice Patterns Study (DOPPS):nutrition guidelines, indicators, and practices. Am JKidney Dis. 2004;44(5 Suppl 2):39-46.

  16. Daugirdas JT, Depner TA, Gotch FA, Greene T,Keshaviah PR, Levin NW, et al. . Comparison ofmethods to predict equilibrated Kt/V in the HEMOpilot study. Kidney Int. 1997; 52: 1395-1405.

  17. Piratelli CM, Telarolli Junior R. Nutritionalevaluation of stage 5 chronic kidney disease patientson dialysis. Sao Paulo Med. J. 2012; 130: 392–97.

  18. Rammohan M, Kalantar-Zadeh K, Liang A,Ghossein C. Megestrol acetate in a moderate dose forthe treatment of malnutrition inflammation complexin maintenance dialysis patients. J Renal Nutrition.2005; 15:345–355.

  19. Bossola M, Tazza L, Giungi S, Luciani G. Anorexiain hemodiálisis patients: an update. Kidney Int. 2006;70:417–422.

  20. Wong S, Pinkney J. Role of cytokines in regulatingfeeding behavior. Current Drug Targets 2004; 5:251–263.

  21. Akpele L, Bailey JL. Nutrition counseling impactsserum albumin levels. J Ren Nutr. 2004;14(3):143-8.

  22. Tomayko EJ, Kistler BM, Fitschen PJ, WilundKR. Intradialytic protein supplementation reducesinflammation and improves physical function inmaintenance hemodialysis patients. J Ren Nutr.2015;25(3):276-83.

  23. Sezer S, Bal Z, Tutal E, Uyar ME, Acar NO.Long-term oral nutrition supplementation improvesoutcomes in malnourished patients with chronickidney disease on hemodialysis. JPEN J ParenterEnteral Nutr. 2014;38(8):960-5.

  24. Lacson E, Jr., Wang W, Zebrowski B, Wingard R,Hakim RM. Outcomes associated with intradialyticoral nutritional supplements in patients undergoingmaintenance hemodialysis: a quality improvementreport. Am J Kidney Dis. 2012;60(4):591-600.

  25. Scott MK, Shah NA, Vilay AM, Thomas J, 3rd,Kraus MA, Mueller BA. Effects of peri dialytic oralsupplements on nutritional status and quality oflife in chronic hemodialysis patients. J Ren Nutr.2009;19(2):145-52.

  26. Caglar K, Fedje L, Dimmitt R, Hakim RM, ShyrY, Ikizler TA. Therapeutic effects of oral nutritionalsupplementation during hemodialysis. Kidney Int.2002;62(3):1054-9.

  27. Rattanasompattikul M, Molnar MZ, LeeML, Dukkipati R, Bross R, Jing J, et al. . Anti-Inflammatory and Anti-Oxidative Nutrition inHypoalbuminemic Dialysis Patients (AIONID)study: results of the pilot-feasibility, double-blind,randomized, placebo-controlled trial. J CachexiaSarcopenia Muscle. 2013;4(4):247-57.

  28. Dong J, Sundell MB, Pupim LB, Wu P, ShintaniA, Ikizler TA. The effect of resistance exercise toaugment long-term benefits of intradialytic oralnutritional supplementation in chronic hemodialysispatients. J Ren Nutr. 2011;21(2):149-59.

  29. Eknoyan G, Beck GJ, Cheung AK, et al. . Effect ofDialysis Dose and Membrane Flux in MaintenanceHemodialysis. N Engl J Med 2002; 347:2010-2019

  30. Vaziri ND, Norris K. Lipid disorders and theirrelevance to outcomes in chronic kidney disease.Blood Purif. 2011; 31:189-196.

  31. Bowden RG, Wilson RL. Malnutrition,inflammation, and lipids in a cohort of dialysispatients. Postgrad Med. 2010; 122:196-202.

  32. Chmielewski M, Verduijn M, Drechsler C, LindholmB, Stenvinkel P, Rutkowski B et al. . Low cholesterolin dialysis patients--causal factor for mortality or aneffect of confounding? Nephrol Dial Transplant. 2011;26:3325-3331.

  33. Kim SM, Lee CH, Oh YK, Joo KW, Kim YS, KimS et al. . The effects of oral iron supplementation onthe progression of anemia and renal dysfunction inpatients with chronic kidney disease. Clin Nephrol.2011; 75:472-479.

  34. Song WJ, Sohng KY. Effects of progressive resistancetraining on body composition, physical fitness andquality of life of patients on hemodialysis. J. KoreanAcad. Nurs. 2012; 42: 947–56.

  35. Chazot C, Laurent G, Charra By cols.: Malnutritionin long-term haemodialysis survivors. Nephrol DialTransplant 2001; 16(1):61-9.

  36. FangW, Yang X, Kothari J, et al. .: Patient andtechnique survival of diabetics on peritoneal dialysis:one center’s experience and review of the literature.Clin Nephrol 2008; 69:193-200.

  37. Lawson JA, Lazarus R, Kelly JJ: Prevalence andprognostic significance of malnutrition in chronicrenal insufficiency. J Ren Nutr 2001; 11:16-22.

  38. Kimmel PL, Chawla LS, Amarasinghe A, et al. .:Anthropometric measures, cytokines and survivalin haemodialysis patients. Nephrol Dial Transplant2003; 18:326-32.

  39. Beddhu S, Pappas LM, Ramkumar N, et al. .:Effects of body size and body composition on survivalin hemodialysis patients. J Am Soc Nephrol 2003;14:2366-72

  40. Dong J, Li YJ, Lu XH, et al. .: Correlations of leanbody mass with nutritional indicators and mortalityin patients on peritoneal dialysis. Kidney Int 2008;73:334-40

  41. Kovesdy CP, Kalantar-Zadeh K: Why is proteinenergywasting associated with mortality in chronickidney disease? Semin Nephrol 2009:29:3-14




2020     |     www.medigraphic.com