Nutritional status in the HEMO study cohort at baseline

Rocco, Michael V.; Paranandi, Lata; Burrowes, Jerrilynn D.; Cockram, David B.; Dwyer, Johanna; Kusek, John W.; Leung, June; Makoff, Rhoda; Maroni, Bradley J.; Poole, Diane J.

doi:10.1053/ajkd.2002.30543

Cited by 120 publications

(91 citation statements)

References 39 publications

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“…Differences may therefore represent the effect of age rather than disease and its treatment. Nevertheless, our patients represent a fairly typical cohort in terms of age (11), energy (30), protein (30), phosphate (31) and calcium (32) intake, and percentage achievement of biochemical targets (11). Samples were collected in the nonfasting state, which may have influenced the variations we observed.…”

Section: Discussionmentioning

confidence: 99%

Variability of Parathyroid Hormone and Other Markers of Bone Mineral Metabolism in Patients Receiving Hemodialysis

Gardham¹,

Stevens

Delaney

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Clinical management of mineral bone disorder in patients with kidney failure is guided by biochemical targets, in particular parathyroid hormone (PTH) concentration. The biologic variation of PTH and other bone mineral markers was measured in hemodialysis patients to better define their role in management.Design, setting, participants, & measurements: Intact PTH, biointact (whole-molecule) PTH, calcium, albumin-adjusted calcium, phosphate, and alkaline phosphatase (ALP) were measured in nonfasting samples obtained twice a week (both short-dialysis interval) over a 6-week period in 22 stable hemodialysis patients. Concurrently, samples were obtained from 12 healthy volunteers. Intraindividual coefficients of variance (CV I ) were calculated and used to derive the reference change value (RCV) required to be 95% certain that a change has occurred.Results: CV I of all markers was significantly (P < 0.05) greater in patients than in healthy volunteers. For phosphate, ALP, and PTH this implies that an increased number of samples is required to estimate an individual's homeostatic set point. CV I of intact PTH was 25.6% in hemodialysis patients and 19.2% in healthy volunteers. A greater RCV should be used for patients (72%) compared with healthy volunteers (54%). Ideally 26 specimens should be measured to estimate a patient's intact PTH homeostatic set point (within ؎10%) with 95% probability. The CV I of biointact PTH was at least as high as that for intact PTH.Conclusions: The uncertainty of PTH estimation in an individual significantly undermines its value as a tool in the management of chronic kidney disease-mineral bone disorder using current management approaches.

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Section: Discussionmentioning

confidence: 99%

Variability of Parathyroid Hormone and Other Markers of Bone Mineral Metabolism in Patients Receiving Hemodialysis

Gardham¹,

Stevens

Delaney

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…Dietary Nutrient Intake in Patients with CKD. A frequent and important cause of PEW in patients with advanced CKD is inadequate dietary protein and energy intake relative to their needs (9,10), which is primarily due to uremic anorexia. Anorexia has long been considered the hallmark of advanced CKD.…”

Section: Prevention Of Pew: a Cause-specific Approachmentioning

confidence: 99%

A Patient with CKD and Poor Nutritional Status

İkizler

2013

Clinical Journal of the American Society of Nephrology

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SummaryProtein energy wasting is common in patients with CKD and ESRD and is associated with adverse clinical outcomes, such as increased rates of hospitalization and death, in these patients. A multitude of factors can affect the nutritional and metabolic status of patients with CKD, including decreased dietary nutrient intake, catabolic effects of renal replacement therapy, systemic inflammation, metabolic and hormonal derangements, and comorbid conditions (such as diabetes and depression). Unique aspects of CKD also confound reliable assessment of nutritional status, further complicating management of this comorbid condition. In patients in whom preventive measures and oral dietary intake from regular meals cannot help them maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is effective in replenishing protein and energy stores. The advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic steroids and exercise, with nutritional supplementation or alone, improve protein stores and represent potential additional approaches for the treatment of PEW. There are several emerging novel therapies, such as appetite stimulants, anti-inflammatory interventions, and anabolic agents.

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“…1,9 Batista, Vieira and Azevedo 44 assessed the nutritional status of 55 HD patients with a mean age of 48.5 years. In a study of 165 patients on dialysis in the Brazilian State of Amazonas, the mean age was 44.9 ± 15 years.…”

Section: Correlation Between the Sga Adapted To The Patient W I T H Cmentioning

confidence: 99%

Desnutrição na insuficiência renal crônica: qual o melhor método diagnóstico na prática clínica?

Oliveira¹,

Kubrusly²,

Mota³

et al. 2010

J. Bras. Nefrol.

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Nutritional status in the HEMO study cohort at baseline

Cited by 120 publications

References 39 publications

Variability of Parathyroid Hormone and Other Markers of Bone Mineral Metabolism in Patients Receiving Hemodialysis

Variability of Parathyroid Hormone and Other Markers of Bone Mineral Metabolism in Patients Receiving Hemodialysis

A Patient with CKD and Poor Nutritional Status

Desnutrição na insuficiência renal crônica: qual o melhor método diagnóstico na prática clínica?

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