Protein Losses and Urea Nitrogen Underestimate Total Nitrogen Losses in Peritoneal Dialysis and Hemodialysis Patients

Salame, Clara; Eaton, Simon; Grimble, G.; Davenport, Andrew

doi:10.1053/j.jrn.2018.01.016

Cited by 26 publications

(22 citation statements)

References 28 publications

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“…Further investigation is needed to confirm this because we did not measure urinary protein excretion in this study. It has also been reported that the amount of albumin lost during PD is greater than that lost during conventional HD [29,30]. Therefore, serum albumin level was a significant predictor of serum zinc level in patients on PD but not in those on HD.…”

Section: Discussionmentioning

confidence: 92%

Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

et al. 2020

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Background: It is known that patients on hemodialysis (HD) are prone to developing zinc deficiency due to removal of zinc by HD, inadequate dietary intake, and reduced gastrointestinal zinc absorption. However, the prevalence of zinc deficiency in patients on peritoneal dialysis (PD) has not been well established. Methods: Serum zinc levels were compared between 47 patients on PD and 47 patients on HD matched for age, sex, and duration of dialysis. A serum zinc level < 60 μg/dL was defined as clinical zinc deficiency and a level of 60–80 μg/dL as subclinical zinc deficiency. The prevalence of zinc deficiency and associated clinical factors were determined in both groups. Results: Clinical zinc deficiency was found in 59.6% of the PD group and 70.2% of the HD group (p = 0.391). Subclinical zinc deficiency was found in 40.4% of the PD group and 29.8% of the HD group. Age, body mass index, and serum albumin level were identified as independent predictors of zinc deficiency in the PD group by multivariate analysis. Conclusions: A higher prevalence of clinical and subclinical zinc deficiency was found in patients on PD. The rates were comparable between patients on PD and those on HD after adjustment for confounding factors.

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Section: Discussionmentioning

confidence: 92%

Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

et al. 2020

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“…dialyzer, penurunan kualitas membran dialyzer, serta perbesaran diameter pori-pori membran dialyzer dapat berpotensi menyebabkan hilangnya protein, lemak, dan glukosa (Qureshi et al, 2016;Salame et al, 2018). Penelitian sebelumnya pada pasien yang menggunakan low-flux hemodialyzers yang telah digunakan kembali, didapatkan sekitar 16 gram nitrogen yang hilang dalam sekali HD, yang setara dengan 100 gram protein (Salame et al, 2018). Oleh karena itu, pemantauan status gizi harus dilakukan pada pasien PGK (Cupisti et al, 2010).…”

Section: Perubahan Permeabilitas Membranunclassified

Comparison Profile of Nutrition Status in Stage V Chronic Kidney Disease Patients Hemodialyzing Using New and Reuse Dialyzer

Hermansyah¹,

Kurniasari

Fatmawati³

2019

AMS

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AbstrakPenyakit ginjal kronis stadium V merupakan penyakit yang ditandai dengan laju filtrasi glomerulus yang mencapai <15 ml/menit per 1,73m 2 . Hemodialisis merupakan salah satu terapi penyakit ginjal kronis stadium V tetapi menghabiskan dana terbanyak dibandingkan terapi lainnya. Penggunaan kembali dialyzer diharapkan dapat menurunkan biaya hemodialisis tetapi menggunakan kembali dialyzer dapat mempengaruhi hemodialisis karena terjadi perubahan permeabilitas, penurunan kualitas, serta perbesaran diameter pori-pori membran dialyzer yang menyebabkan hilangnya albumin serum, protein, lemak, dan glukosa. Berdasarkan analisis data yang meliputi pengukuran albumin serum, indeks masa tubuh dan tebal lemak kulit bisep dan trisep, tidak terdapat perbedaan yang signifikan dengan nilai signifikansi masing-masing adalah p=0,111 (albumin serum sebelum hemodialisis menggunakan dialyzer baru dan reuse), p=0,017 (albumin serum sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,062 (selisih albumin serum sebelum dan sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,183 (indeks masa tubuh sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,326 (tebal lemak kulit bisep sesudah hemodialisis menggunakan dialyzer baru dan reuse), dan p=0,161 (tebal lemak kulit trisep sesudah hemodialisis menggunakan dialyzer baru dan reuse).Kata kunci: penyakit ginjal kronis stadium V, hemodialisis, albumin serum, indeks masa tubuh, tebal lemak kulit bisep dan trisep, dialyzer reuse Abstract Stage V chronic kidney disease is a kidney disease with a glomerular filtration rate that reaches <15 ml/minute per 1.73m2. Hemodialysis is one of the therapies for stage V chronic kidney disease but spends the most funds compared to other therapies. Reusing the dialyzer can reduce the cost of hemodialysis, but it can affect hemodialysis because of changes in permeability, decreased quality, and enlargement of the diameter of the dialyzer membrane which causes loss of serum albumin, protein, fat, and glucose. Based on the analysis data which included measurement of serum albumin levels, body mass index and biceps and triceps skinfold thickness, there were no significant differences with the significance values respectively p=0.111 (serum albumin level before hemodialysis using new and reuse dialyzer), p=0.017 (serum albumin level after hemodialysis using new and reuse dialyzer), p=0.062 (difference in serum albumin levels before and after hemodialysis using new and reuse dialyzer), p=0.183 (body mass index after hemodialysis using new and reuse dialyzer), p=0.326 and p=0.161 (biceps and triceps skinfold thickness after hemodialysis using new and reuse dialyzer).

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“…Notably, only about 70% of these nitrogen losses were due to losses of urea and protein suggesting that far more losses of peptides, nucleotides, organic acids and amino acids occur than is commonly believed to be the case. 6 The 10 year risk of developing dementia in 66-70 year old patients initiating HD was 19%, far higher than that in the general population.…”

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confidence: 96%

“…A study of protein and nitrogen losses during HD (N = 40) and PD (N = 68) found greater weekly protein losses in PD (mean, 46.6 gm) than in HD (25.9 gm) but similar nitrogen losses. Notably, only about 70% of these nitrogen losses were due to losses of urea and protein suggesting that far more losses of peptides, nucleotides, organic acids and amino acids occur than is commonly believed to be the case …”

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confidence: 99%

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Sherman¹

2019

Seminars in Dialysis

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Protein Losses and Urea Nitrogen Underestimate Total Nitrogen Losses in Peritoneal Dialysis and Hemodialysis Patients

Cited by 26 publications

References 28 publications

Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

Comparison Profile of Nutrition Status in Stage V Chronic Kidney Disease Patients Hemodialyzing Using New and Reuse Dialyzer

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