The Effect of BCAA and ISO-WHEY Oral Nutritional Supplements on Dialysis Adequacy

Afaghi, Effat; Tayebi, Ali; Ebadi, Abbas; Sobhani, Vahid; Einollahi, Behzad; Tayebi, Mehdi

doi:10.5812/numonthly.34993

Cited by 10 publications

(13 citation statements)

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“…cant goals of the health care team is high adequacy of dialysis (8). Dialysis adequacy affects appetite, intake of nutrients, and nutrition, while dialysis inadequacy is an important factor in patients' malnutrition and mortality (9). To determine the adequacy of dialysis, urea reduction ratio (URR) and kt/v (k: filter urea clearance used, t: dialysis duration, and v: volume of urea distribution or volume of water distribution are calculated.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Nutritional Status Based on Subjective Global Assessment and Dialysis Adequacy

et al. 2021

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Background: Malnutrition is common in patients undergoing hemodialysis and leads to a decrease in dialysis adequacy. The evaluation of dialysis adequacy is very important. Objectives: This study was done to investigate the relationship between patients’ nutrition status based on Subjective Global Assessment (SGA) and their dialysis adequacy. Methods: This cross-sectional descriptive study was conducted in Tehran, Iran, in 2019. Three hundred qualified patients were selected by cluster sampling. Before the dialysis session, measurement of height and weight and blood sampling for albumin, total iron-binding capacity (TIBC), blood urea nitrogen (BUN), and creatinine (Cr) assessment were performed. After the dialysis session, measurement of weight and second sampling for BUN were done. SGA forms were filled by patients. Patients’ dialysis adequacy was calculated based on the DaugirdasII formula, and data were analyzed using SPSS 21. Results: From 300 patients, 128 cases (42.7%) had normal nutrition status, while 148 cases (49.3%) had mild to moderate malnutrition and 24 cases (8%) had severe malnutrition with mean dialysis adequacy of 1.07. The present study showed a significant statistical relationship between malnutrition and education (P < 0.001), body mass index (BMI) (P = 0.03), albumin (P < 0.001), TIBC (P < 0.001), and dialysis adequacy (P < 0.001). Gender, age, and dialysis duration showed no significant relationship with nutrition status based on the SGA index. Conclusions: The findings showed a high relative frequency of malnutrition and a decrease in patients’ dialysis adequacy, which emphasize the patient’s educational level, proper management of nutrition along with regular consultations by nutritionists, better implementation of the dialysis procedure, and regular follow-up of dialysis adequacy.

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Section: Introductionmentioning

confidence: 99%

The Relationship Between Nutritional Status Based on Subjective Global Assessment and Dialysis Adequacy

et al. 2021

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“…Patients' perception and experience of an efficient dialysis, subjective perception of the physical and spiritual-psychological signs of adequate dialysis, and patients' expectations and feelings about their health status during the dialysis procedure are all associated with subjective aspect of dialysis adequacy (43). On the other hand, the role of patients' problems and disorders, the admissible outcomes for the patients, the bearable costs and efforts, and the financial problems they face cannot be taken for granted (34). Thus, a comprehensive evaluation of dialysis adequacy requires a method that can take both subjective and objective aspects into account.…”

Section: Discussionmentioning

confidence: 99%

“…-Since low urea reveals bad nutritional status and protein-energy malnutrition (34), rather than sufficient urea removal through dialysis, monitoring serial blood urea is not enough to evaluate dialysis adequacy (5).…”

Section: The Negative Points Of Kt/v As a Marker Of Dialysis Adequacymentioning

confidence: 99%

Kt/V: A Magical Formula for Dialysis Adequacy: A Critical Review

Biniaz

Moonaghi

Froutan

et al. 2017

Jundishapur J Chronic Dis Care

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Long-term prognosis of chronic hemodialysis patients is affected by dialysis adequacy; thus, evaluation of dialysis adequacy plays a key role in assessment of healthcare system in all countries. Currently, urea reduction ratio (URR) and Kt/V are applied to evaluate dialysis adequacy; however, due to the inconsistency between their results and patient outcome, their application has been questioned. Herein, we aimed at broadly reviewing the shortcomings of Kt/V index for appraisal of dialysis adequacy. For this purpose, we searched MEDLINE, EMBASE, Science direct, Cochrane Library, Scopus, and Google Scholar for relevant literature without any time or language limitations from May 2016 to February 2017. The applied keywords were "dialysis adequacy" OR "dialysis sufficiency" OR "dialysis competence" OR "dialysis efficiency". We summarized all the studies questioning the success of Kt/V index in appraisal of dialysis adequacy to investigate whether Kt/V is still an appropriate index for evaluation of adequacy of different types of dialysis. The results of this study revealed that Kt/V is not the best criterion and one cannot be assured of dialysis adequacy solely based on this criterion.Keywords: Dialysis Adequacy, Kt/V, Dialysis Sufficiency, Dialysis Competence, Dialysis Efficiency ContextChronic kidney disease (CKD) is a progressive and irreversible malfunction with various systemic adverse effects (1). End stage renal disease (ESRD) is a condition in which the patient requires dialysis or renal transplant to survive. Annually, thousands of people die of ESRD (2). Change in parameters associated with lifestyle, such as hypertension and diabetes, can explain the rising incidence rate of this disease (3). The prevalence of this disease is on a growing trend in the developed and developing countries (4). According to the national health organization of America reports, the prevalence rate of this debilitating disease has increased by 600% during 1980 and 2009 (5).In Iran, prevalence and incidence of ESRD is also on the rise (6), so prevalence and incidence of ESRD, with an increase of 460 times, have risen from 137 per 1,000,000 cases in 1997 to 238 cases in 2000 and to 436 cases in 2007 (7, 8). Based on a report by the management center for transplantation and special diseases, approximately 33,000 patients received alternative therapies for kidney during 2007 (8, 9).Hemodialysis replaces some of the renal functions in ESRD patients to remove waste products and extra fluids from the blood when the kidneys cannot function adequately (10, 11). Thus, with higher dialysis adequacy, the patient would have a better health status and would suffer less from adverse effects of renal failure (12). Long-term prognosis of hemodialysis patients is affected by dialysis adequacy (13). Dialysis adequacy is considered a predictor of patient mortality and primary outcomes (14). The patients undergoing dialysis with high adequacy live as long as those receiving kidney transplant (15, 16).The Kt/V index, as a criterion for inve...

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“…Many dialysis units now offer these oral supplements, at least to hypoalbuminemic patients, and a number of studies have addressed their effect on nutritional status and albumin or prealbumin levels [111][112][113][114][115][116][117]. Overall, reports are favorable on all outcomes tested; an interesting suggestion is the fact that providing oral nutritional supplements during dialysis seems to reduce the number of missed dialysis sessions, thus underlining the psychological importance that nutritional care has for our patients [116].…”

Section: Oral Nutritional Supplementsmentioning

confidence: 99%

Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

et al. 2020

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Dialysis and nutrition are two sides of the same coin—dialysis depurates metabolic waste that is typically produced by food intake. Hence, dietetic restrictions are commonly imposed in order to limit potassium and phosphate and avoid fluid overload. Conversely, malnutrition is a major challenge and, albeit to differing degrees, all nutritional markers are associated with survival. Dialysis-related malnutrition has a multifactorial origin related to uremic syndrome and comorbidities but also to dialysis treatment. Both an insufficient dialysis dose and excessive removal are contributing factors. It is thus not surprising that dialysis alone, without proper nutritional management, often fails to be effective in combatting malnutrition. While composite indexes can be used to identify patients with poor prognosis, none is fully satisfactory, and the definitions of malnutrition and protein energy wasting are still controversial. Furthermore, most nutritional markers and interventions were assessed in hemodialysis patients, while hemodiafiltration and peritoneal dialysis have been less extensively studied. The significant loss of albumin in these two dialysis modalities makes it extremely difficult to interpret common markers and scores. Despite these problems, hemodialysis sessions represent a valuable opportunity to monitor nutritional status and prescribe nutritional interventions, and several approaches have been tried. In this concept paper, we review the current evidence on intradialytic nutrition and propose an algorithm for adapting nutritional interventions to individual patients.

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The Effect of BCAA and ISO-WHEY Oral Nutritional Supplements on Dialysis Adequacy

Cited by 10 publications

References 14 publications

The Relationship Between Nutritional Status Based on Subjective Global Assessment and Dialysis Adequacy

The Relationship Between Nutritional Status Based on Subjective Global Assessment and Dialysis Adequacy

Kt/V: A Magical Formula for Dialysis Adequacy: A Critical Review

Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

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