<scp>B</scp>ritish Dietetic Association evidence‐based guidelines for the protein requirements of adults undergoing maintenance haemodialysis or peritoneal dialysis

Naylor, H. L.; Jackson, Helena; Walker, Graeme; Macafee, S.; Magee, Karen L.; Hooper, Lee; Stewart, Laura; MacLaughlin, Helen

doi:10.1111/jhn.12052

Cited by 57 publications

(54 citation statements)

References 37 publications

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“…As far as the quality of protein intake is concerned, it is noteworthy that more than 50% of dietary protein consumed by our patients was of animal origin. This finding is in line with the recommendations [20,22], although some authors believe more evidence is needed [30]. …”

Section: Discussionsupporting

confidence: 81%

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Bovio¹,

Esposito

Montagna

et al. 2016

Nephron

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Background/Aims: It is very important to assess the nutritional intake in patients on dialysis given the high prevalence of poor nutritional status of those in this population. The aim of this study was to assess nutrient intakes in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: A clinical cross-sectional study was conducted over 7 days on 14 dialysis patients (98 days) who were trained to keep a weighed food record and a 7-day food diary. Nutrient intake adequacy was compared with specific guidelines for Italians and dialysis patients. Results: The mean daily protein intake (0.92 ± 0.36 g/kg) and energy intake (EI; 25.3 ± 7.4 kcal/kg) were inadequate according to the European best practice guidelines (EBPG). The ratio of EI to resting energy expenditure was 1.22. Inadequate intakes, compared to the EBPG, were found for calcium (525 ± 162 mg/day) and iron (8.7 ± 2.1 mg/day). Dietary fiber (14.7 ± 8.7 g/day), niacin (14.4 ± 5.2 mg/day), thiamine (0.8 ± 0.3 mg/day) and riboflavin (1.1 ± 0.4 mg/day) were also inadequate according to the Italian recommended dietary allowances (LARN). HD patients did not display different nutrient intakes between the dialysis days and the interdialytic period. Overall, the percentage of days during which nutrient recommendations were not satisfied ranged from 16 to 100% depending on the nutrient. Conclusion: Macronutrient and micronutrient intakes in HD and PD patients are largely inadequate compared to the EBPG. The weighed dietary record appears to be a useful and accurate tool for individual assessment of food intake in motivated patients. No nutrient intake differences were found between dialytic and interdialytic days in patients on HD.

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Section: Discussionsupporting

confidence: 81%

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Bovio¹,

Esposito

Montagna

et al. 2016

Nephron

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“…It is clear that each DI study uses its own interpretation of body weight, which confounds comparison. 52 These differences in methodology make it hard to generalize findings; however, studies in both HD and PD patients show low DEI and DPI.…”

Section: Challenges Of DI Studiesmentioning

confidence: 97%

A Review of Dietary Intake Studies in Maintenance Dialysis Patients

Therrien

Byham‐Gray

Beto

2015

Journal of Renal Nutrition

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“…Naylor et al (2013) performed a literature review aiming to elaborate guidelines on the protein requirement of hemodialysis patients and concluded that the intake of 1.1 g/kg/day is able to meet their needs and avoid protein malnutrition. However, in this study protein intake was lower than this value, showing the need for intervention and nutritional orientation, since this intake, when insufficient, is related to higher mortality 15 . In the present study there was a statistically significant negative correlation (p = 0.02) between fat mass and protein intake (g/kg), indicating that the lower the protein intake, the greater the fat mass.…”

Section: Methods Of Nutritional Evaluation Between Patients In Hemodimentioning

confidence: 64%

Methods of nutritional evaluation between patients in hemodialysis

Bertoni¹,

Bettinelli²,

Pasqualotti³

et al. 2017

Mundo Saúde

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Chronic kidney disease is a public health problem. Characterizing the nutritional profile of these patients allows early diagnosis of possible nutritional risks. The objective was to evaluate the nutritional status and dietary intake of hemodialysis patients. A cross-sectional study was performed at a hemodialysis clinic from February to April 2016. Patients 18 years of age or older who underwent treatment for at least three months and were able to perform the Bioimpedance test were included. Nutritional status was determined by Body Mass Index. The Palmar Grip Strength was measured by dynamometer and the Adductor Muscle Thickness of the Thumb was by an adipometer, food intake was analyzed through a 24-hour Food Recall. A Global Subjective Assessment was performed, adapted for kidney patients. Of the 33 patients, 66.7% were males, with a mean age of 57.6 ± 14.2 years. According to the body mass index, eutrophy was prevalent (54.5%). The thickness of the adductor muscle of the thumb showed severe depletion (66.7%). Palmar grip strength ranked 72.7% of patients as malnourished. Body Fat, obtained through Bioimpedance, was high in 57.6%. The Global Subjective Assessment ranked 87.9% of patients with mild malnutrition. According to the 24-hour food recall, the total caloric intake averaged 1493 ± 530 Kcal. The protein mean was 0.88 ± 0.4 g / kg. The study allowed to visualize nutritional alterations, food intake below the recommended amounts, and different classifications of the nutritional state depending on the method used. Thus, a comprehensive nutritional assessment becomes important.

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British Dietetic Association evidence‐based guidelines for the protein requirements of adults undergoing maintenance haemodialysis or peritoneal dialysis

Abstract: Evidence suggests that nutritional status may be maintained with lower protein intakes than previously recommended. However, the evidence base is limited and further randomised controlled trials are required to establish the optimal protein intake for dialysis patients.

Cited by 57 publications

References 37 publications

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

A Review of Dietary Intake Studies in Maintenance Dialysis Patients

Methods of nutritional evaluation between patients in hemodialysis

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