Associations of dietary macronutrients and micronutrients with the traditional and nontraditional risk factors for cardiovascular disease among hemodialysis patients

Abstract

The current study was to examine the association of adequate intake of macronutrients and micronutrients with traditional and nontraditional cardiovascular risk factors in hemodialysis patients.A clinical cross-sectional study was conducted between September 2013 and April 2017 on 492 hemodialysis patients aged 20 years and above, received thrice-weekly hemodialysis treatment for at least 3 months, adequate dialysis quality (equilibrated Kt/V ≥ 1.2 g/kg/d) from 7 hospital-based hemodialysis centers in Taiwan. The dietary intake was evaluated by the 3-day dietary record, and a 24-hour dietary recall. Biochemical parameters were archived from laboratory tests. The cardiovascular disease (CVD) risk factors were defined by the Kidney Disease Outcomes Quality Initiative (K/DOQI) Clinical Practice Guidelines. The adequate dietary intake of macronutrients and micronutrients was recommended by the European Best Practice Guidelines, K/DOQI, and Institute of Medicine guidelines. Logistic regression analysis was used.All hemodialysis patients had CVD risks, the lowest proportion of patients with adequate intake of macronutrients and micronutrients were 8.7% and 1.8%, respectively. The adequate dietary intake associated with lower likelihood of having CVD risks in hemodialysis patient by 47% to 84%, including 39% to 58% lower hypertension, 37% to 50% lower dyslipidemia, 42% to 63% diabetes mellitus, 44% to 84% lower obesity, 58% lower low calcium, 38% lower hyperparathyroidism, 47% to 64% lower hyperhomocysteinemia, and 41% to 67% lower inflammation, 63% to 74% lower hypoalbumin, 73% lower inadequate normalized protein nitrogen appearance.Adequate dietary nutrients intake may reduce the cardiovascular risks factors, in turn, to prevent the cardiovascular morbidity and mortality.

Inadequate dietary energy intake associates with higher prevalence of metabolic syndrome in different groups of hemodialysis patients: a clinical observational study in multiple dialysis centers

“…The study patients in the current study fulfilled the recruitment criteria as mentioned elsewhere [ 29 – 31 ].…”

Dietary Daily Sodium Intake Lower than 1500 mg Is Associated with Inadequately Low Intake of Calorie, Protein, Iron, Zinc and Vitamin B1 in Patients on Chronic Hemodialysis

“…We used a 3-day food diary to assess sodium intake, a method that may imply inherent errors of dietary assessment and can be the cause of under-and over-reporting. Nevertheless, there is large recent evidence that the 3-day diet diary is a simple, useful, and effective method to measure the intake of macro-and micro-nutrients in patients on chronic hemodialysis [43][44][45][46][47]. The strength is that we included patients of different towns of Italy and consequently the data can be considered representative of the Italian population of patients on chronic hemodialysis.…”

Plasma metabolomics of children with aberrant serum lipids and inadequate micronutrient intake

“…In rats fed a high cholesterol diet, dietary supplementation with beta-carotene improved the serum lipid profile and increased fecal excretion of cholesterol compounds, indicating that beta-carotene may act to decrease cholesterol absorption in the intestine, thus facilitating its elimination [ 58 ]. While the mechanisms for micronutrient contributions to CVD prevention is well-recognized (e.g., inflammation, anti-oxidation) [ 22 , 59 – 60 ], further information on the suite of lipid metabolism impacts is warranted to identify the clinical importance.…”