Nutritional Profile of Continuous Ambulatory Peritoneal Dialysis Patients

Jacob, Vinita; Marchant, Paul; Wild, Gary; Brown, C. B.; Moorhead, P J; Nahas, A. Meguid El

doi:10.1159/000188668

Cited by 23 publications

(17 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prealbumin is excreted by the kidney via glomerular filtration [26] . Moreover, in previous studies [26] , [27] , recommendations for the routine use of serum prealbumin levels as a marker are tempered by the fact that prealbumin levels are increased in renal failure, presumably due to impaired degradation by the kidney [11] . These mechanisms may affect this negative correlation between prealbumin and residual renal function in our results.…”

Section: Discussionmentioning

confidence: 99%

“…Serum prealbumin levels decline in response to inadequate protein intake and acute or chronic inflammation [10] . However, prealbumin levels may increase in renal failure, presumably because of impaired degradation by the kidney, and thus may not correlate with changes in other nutritional parameters [11] . Nonetheless, many studies have suggested that the serum prealbumin concentration is independently associated with mortality in hemodialysis patients, even after adjustment for other nutritional parameters including albumin [5] , [12] , [13] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis

Lee

Cho

Kwon

et al. 2016

Kidney Research and Clinical Practice

View full text Add to dashboard Cite

BackgroundPrealbumin, a sensitive marker for protein–energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients.MethodsIn total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation. Patients were classified into 2 groups according to prealbumin level: high prealbumin (≥ 40 mg/dL) and low prealbumin (< 40 mg/dL).ResultsThe patients in the low-prealbumin group were older and had more comorbidities such as diabetes and cardiovascular diseases compared with the patients in the high-prealbumin group. Mean subjective global assessment scores were lower, and the high-sensitivity C-reactive protein levels were higher in the low-prealbumin group. Serum creatinine, albumin, and transferrin levels; percent lean body mass; and normalized protein catabolic rate were positively associated, whereas subjective global assessment scores and high-sensitivity C-reactive protein levels were negatively associated with prealbumin concentration. During the median follow-up of 49 months, patients in the lower prealbumin group had a higher mortality rate. Multivariate analysis revealed that prealbumin < 40 mg/dL (hazard ratio, 2.30; 95% confidence interval, 1.14–4.64) was an independent risk factor for mortality. In receiver operating characteristic curves, the area under the curve of prealbumin for mortality was the largest among the parameters.ConclusionPrealbumin levels were an independent and sensitive predictor for mortality in incident PD patients, showing a good correlation with nutritional and inflammatory markers.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis

Lee

Cho

Kwon

et al. 2016

Kidney Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Its impairment by inflammatory factors is involved in muscle proteolysis [ 49 ], but the serum concentrations are elevated in CKD patients [ 7 ]. It has been also been associated with malnutrition [ 54 ]. It was included here as a possible mediator of both inflammatory and metabolic derangements of uremic milieu.…”

Section: Methodsmentioning

confidence: 99%

Association of Uremic Toxins and Inflammatory Markers with Physical Performance in Dialysis Patients

Pajek

Jerman

Osredkar

et al. 2018

Toxins

View full text Add to dashboard Cite

Association of higher serum levels of uremic toxins and inflammatory markers with poorer physical performance is understudied. We measured the six-minute walk test (6MWT), 10 repetition sit-to-stand test (STS-10), handgrip strength (HGS), and Human Activity Profile (HAP) questionnaire score in 90 prevalent hemodialysis patents, with low comorbidity to reduce the potential confounding of concomitant disease. Midweek pre-dialysis serum levels of asymmetric dimethyl-arginine (ADMA), β2-microglobulin (B2M), high-sensitivity C-reactive protein (hs-CRP), indoxyl sulfate (IS), insulin-like growth factor 1 (IGF-1), interleukin 6 (IL-6), myostatin, and urea were analyzed as predictor parameters of physical performance measures in adjusted models. Serum levels of most measured toxins were not significantly related to performance, except for ADMA, which was significantly related to poorer performance in the STS-10 test (B = 0.11 ± 0.03 s, p < 0.01). Higher hs-CRP was associated with poorer results in the 6MWT (B = −2.6 ± 0.97 m, p < 0.01) and a lower HAP score (B = −0.36 ± 0.14, p = 0.01). There were no other significant associations found. We conclude that inflammation may be a more important pathway to physical impediment than uremic toxemia. This suggests that there is a large physical rehabilitation potential in non-inflamed uremic patients.

show abstract

“…In PD the problem of malnutrition [143] and decreased muscle mass [144] is well known. Since the marketing of AA-containing dialysis solutions, several studies have been reported.…”

Section: Treatment With Aasmentioning

confidence: 99%