Macronutrients, micronutrients intake and inflammation in hemodialysis patients

Abstract

Inflammation in hemodialysis patients occurs since before undergoing hemodialysis. Inflammation is associated with an increase in oxidative stress. Hemodialysis patients are at risk for macronutrients and micronutrients deficiencies which can influence the increase in oxidative stress and inflammation. The purpose of this study was to evaluate the intake of micronutrients and inflammatory status in hemodialysis patients. This study was a cross-sectional study with 76 hemodialysis patients (40 male and 36 female) who attended in two hemodialysis centers of Kendal, Indonesia. After obtaining the written consent, then patients were interviewed food intake consisting of macronutrient and micronutrient intake. Macronutrient and micronutrient intake are obtained by the semi quantitative food frequency method and classified as a deficit (<100% adequacy level) and normal/ more (≥100% adequacy level), according to specific recommendations for individuals undergoing dialysis. Serum albumin was examined using the Brom Cresol Purple (BCP) method with a low category (<3.5 mg.dL-1) and normal (3.5 – 4.5 mg.dL-1). The hs-CRP serum was examined using the ELISA method and categorized as low (<1 mg.L-1), moderate (1 – 3 mg.L-1) and high (> 3 mg.L-1). A descriptive analysis was performed. The results of this study showed that 88.2% deficit energy intake, 84.2% deficit protein intake, 85.5% deficit of vitamin A intake, 85.5% deficit of vitamin C intake, 100% deficit of vitamin E intake, 98, 7% deficit zinc intake , 92.1% deficit copper intake. 63.2% subjects are low level of serum albumin and 61.8% subjects is high level of hs-CRP serum. Macronutrient and micronutrient intake in most hemodialysis patients shows deficit. The serum albumin of most hemodialysis patients shows low level. Serum hs-CRP most hemodialysis patients show high level.

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

“…Indeed, increased indices of oxidative damage along with decreased indices of antioxidant defense have been observed in HD patients post-dialysis [92]. Low antioxidant levels in HD patients may also occur from limited vegetable and fruit intakes preventing hyperkalemia [93]. Resultant low intakes of vitamin A, C, and E and selenium would affect antioxidant defense mechanisms [93,94].…”

“…Low antioxidant levels in HD patients may also occur from limited vegetable and fruit intakes preventing hyperkalemia [93]. Resultant low intakes of vitamin A, C, and E and selenium would affect antioxidant defense mechanisms [93,94]. Additionally, involuntary removal of vitamins also occurs with every HD session as mentioned in Section 3.1.…”

The Effects of Zinc Sulfate Supplementation on Serum Copeptin, C-Reactive Protein and Metabolic Markers in Zinc-Deficient Diabetic Patients on Hemodialysis: A Randomized, Double-Blind, Placebo-Controlled Trial

“…Diabetic kidney disease (DKD), often develops in diabetic patients, and have different aetiologies, but is particularly due to hypertensive nephrosclerosis (1), which is the single most common cause of the end-stage renal disease (ESRD) in the Western populations (2). Mortality is high in patients with ESRD for various reasons, including systemic inflammation and protein energy malnutrition (PEM); hemodialysis patients (HP) are at risk for deficiencies in macronutrients and micronutrients, which can induce oxidative stress and inflammation (3). Levels of inflammatory markers such as C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukins 1,6 and 8 are often increased in HP (4).…”