Malnutrition in patients with chronic kidney disease

Chung, Sungjin; Koh, Eun Sil; Shin, Seok Joon; Park, Cheol Whee

doi:10.4236/ojim.2012.22018

Cited by 41 publications

(45 citation statements)

References 67 publications

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“…This would have deleterious effects by contributing to malnutrition via a reduced lean body mass (Chung et al . ). Saturated fat consumption in all participants exceeded the recommendations, with food sources of saturated fat predominately being full fat dairy foods (milk, cheese and butter) and red meat.…”

Section: Discussionmentioning

confidence: 97%

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Roach

Lambert

Holt

et al. 2017

Journal of Renal Care

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SUMMARY Background People on haemodialysis (HD) are at risk of consuming a poor quality diet. This includes inadequate intake of omega‐3 long chain polyunsaturated fatty acids (n‐3 LCPUFA). Objective This study aims to investigate diet quality, with a particular focus on n‐3 LCPUFA intake, in a population of incentre HD patients. Design Dietary intake was measured using three 24 hour recalls; the Polyunsaturated food frequency questionnaire (PUFA FFQ) and the Total Diet Score (TDS). Dietary intake was also compared to evidence based practice guidelines (EBPG). Nutritional status was assessed using the Patient Generated Subjective Global Assessment (PG SGA). Subjects A total of 32 dialysis patients were recruited, from two regional HD centres in New South Wales, Australia. Main Outcome Measure Diet quality was the main outcome measure. Results Diet quality of study participants was poor, with the majority not meeting the EBPG for energy, protein and potassium. All participants exceeded the recommended amount of saturated fat. The mean TDS of the dialysis cohort was 10.2, which was significantly higher than the TDS of 9.3 of a healthy disease free cohort (p < 0.05). Positive correlations were found between TDS and LC omega‐3 intake (r = 0.392) and TDS and total omega‐6 intake (r = 0.363). Only 22% of participants met the suggested dietary target for n‐3 LCPUFA intake. Conclusion Dialysis patients in this study had suboptimal diet quality. Improvements are required for better adherence to the EBPG. Increased consumption of n‐3 LCPUFA fatty acids may also be of benefit.

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Section: Discussionmentioning

confidence: 97%

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Roach

Lambert

Holt

et al. 2017

Journal of Renal Care

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“…Serum albumin is the most commonly used and reliable nutritional marker in CKD and ESRD patients, and protein-rich foods are the main source of dietary phosphate [ 30 ]. Serum creatinine is a useful biochemical marker for assessing nutritional status in maintenance dialysis patients, as well [ 31 ]. Therefore, a low phosphate level is considered to represent poor nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Low serum phosphate as an independent predictor of increased infection-related mortality in dialysis patients: A prospective multicenter cohort study

et al. 2017

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BackgroundThe 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.MethodsPatients on hemodialysis and peritoneal dialysis were enrolled from a multicenter prospective cohort study in Korea (NCT00931970). The patients were divided into low, normal, and high groups according to their baseline serum calcium or phosphate levels. Cox proportional analysis and a proportional hazards model for the subdistribution of a competing risk were used to calculate hazard ratios (HRs) for the association of serum calcium and phosphate levels with all-cause and cause-specific mortality. Time-dependent values of calcium and phosphate were also evaluated to assess the effect of longitudinal change in mineral metabolism parameters on mortality types.ResultsA total of 3,226 dialysis patients were followed up for a mean of 19.8 ± 8.2 months. Infection was the most common cause of death. Low serum phosphate was significantly associated with all-cause and infection-related death using time-dependent values (HR, 1.43 [95% confidence interval (CI), 1.06–1.93], P = 0.02, and HR, 1.66 [95% CI, 1.02–2.70], P = 0.04, respectively). Low serum phosphate was associated with significantly higher infection-related mortality, especially in patients older than 65 years or on dialysis more than one year or with serum albumin lower than 3.9 g/dL (HR, 2.06 [95% CI, 1.13–3.75], P = 0.02, HR, 2.19 [95% CI, 1.20–4.01], P = 0.01, and HR, 1.77 [95% CI, 1.00–3.13], P = 0.05, respectively). Multinomial logistic regression analysis results suggested that low serum albumin, creatinine, and body mass index correlated with low serum phosphate.ConclusionsLow serum phosphate in dialysis patients was an independent risk factor for infection-related death, especially in elderly patients. Persistently low serum phosphate might be a nutritional biomarker to predict increased susceptibility to infection and in turn worse outcomes in dialysis patients.

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“…Another interesting finding of this study concerns the significant reduction in BMI based on CKD progression. This behavior is explained not only by the fact that patient weight is included in the calculation of the GFR but also given the malnutrition associated with CKD 13,20,21 . In fact, the progressive decrease of BMI might reduce dyslipidemia or glucose levels, thereby promoting a regression of underlying fatty liver disease that contributes to decreased aminotransferase levels 22 .…”

Section: Discussionmentioning

confidence: 99%

The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease

Sette¹,

Lopes²

2015

Clinics

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OBJECTIVE:This study sought to determine the serum aminotransferase levels of patients with predialysis chronic kidney disease and establish their relationships with serum creatinine levels and glomerular filtration rate.METHODS:Patients with chronic kidney disease were evaluated between September 2011 and May 2012. Aminotransferase and creatinine serum levels were measured using an automated kinetic method, and glomerular filtration rates were estimated using the Cockroft-Gault and Modification of Diet in Renal Disease formulas to classify patients into chronic kidney disease stages.RESULTS:Exactly 142 patients were evaluated (mean age: 64±16 years). The mean creatinine serum level and glomerular filtration rate were 3.3±1.2 mg/dL and 29.1±13 mL/min/1.73 m2, respectively. Patients were distributed according to their chronic kidney disease stages as follows: 3 (2.1%) patients were Stage 2; 54 (38%) were Stage 3; 70 (49.3%) were Stage 4; and 15 (10.5%) were Stage 5. The mean aspartate aminotransferase and alanine aminotransferase serum levels showed a reduction in proportion to the increase in creatinine levels (p=0.001 and p=0.05, respectively) and the decrease in glomerular filtration rate (p=0.007 and p=0.028, respectively). Alanine aminotransferase and aspartate aminotransferase serum levels tended to be higher among patients classified as stage 2 or 3 compared with those classified as stage 4 or 5 (p=0.08 and p=0.06, respectively).CONCLUSIONS:The aspartate aminotransferase and alanine aminotransferase serum levels of patients with predialysis chronic kidney disease decreased in proportion to the progression of the disease; they were negatively correlated with creatinine levels and directly correlated with glomerular filtration rate.

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Malnutrition in patients with chronic kidney disease

Cited by 41 publications

References 67 publications

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Low serum phosphate as an independent predictor of increased infection-related mortality in dialysis patients: A prospective multicenter cohort study

The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease

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