NT-proBNP, Cardiometabolic Risk Factors, and Nutritional Status in Hemodialysis Patients

Background.We aimed to evaluate the association between NT-proBNP and malnutrition in HD patients while taking into account the four established categories of parameters for diagnosis of protein energy wasting (PEW).Methods. A cross-sectional study was performed in Afro-Caribbean dialysis patients. One component in each of the 4 categories for the wasting syndrome was retained: serum albumin ≤ 38 g/L, BMI ≤ 23 Kg/m2, serum creatinine ≤ 818 µmol/L, and normalized protein catabolic rate (nPCR) ≤ 0.8 g/kg/day. NT-proBNP was assessed using a chemiluminescence immunoassay. Two multivariate logistic regression models were performed to determine the parameters associated with high NT-proBNP concentrations.Results.In 207 HD patients, 16.9% had PEW (at least three components). LVEF lower than 60% was found in 13.8% of patients. NT-proBNP levels ranged from 125 to 33144 pg/mL. In model 1, high levels of NT-proBNP (≥6243 pg/mL) were independently associated with PEW OR 14.2 (3.25–62.4), male gender 2.80 (1.22–6.57), hsCRP > 5 mg/L 3.90 (1.77–8.57), and dialysis vintage > 3 years 3.84 (1.35–10.8). In model 2, LVEF OR was 0.93 (0.88–0.98). NT-proBNP concentrations were significantly higher when the PEW component number was higher.Conclusion.In dialysis patients, high NT-proBNP levels must draw attention to cardiac function but also to nutritional status.

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Predicational ability of phase angle on protein energy wasting in kidney disease patients with renal replacement therapy: A cross‐sectional study

Food Science & Nutrition ◽

10.1002/fsn3.2310 ◽

2021 ◽

Author(s):

Haiteng Zhou ◽

Wenlong Yao ◽

Da Pan ◽

Guiju Sun

Keyword(s):

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

Phase Angle ◽

Cross Sectional Study ◽

Sectional Study ◽

Protein Energy Wasting ◽

Cross Sectional ◽

Protein Energy

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Relationship between Vascular Calcification, Protein-Energy Wasting Syndrome, and Sarcopenia in Maintenance Automated Peritoneal Dialysis

Life ◽

10.3390/life11070666 ◽

2021 ◽

Vol 11 (7) ◽

pp. 666

Author(s):

Gustavo Leal-Alegre ◽

Claudia Lerma ◽

Gabriela Leal-Escobar ◽

Bernardo Moguel-González ◽

Karen Belén Martínez-Vázquez ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Peritoneal Dialysis ◽

Vascular Calcification ◽

Automated Peritoneal Dialysis ◽

Dialysis Patients ◽

Protein Energy Wasting ◽

Wasting Syndrome ◽

Protein Energy ◽

Inflammation Score

Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.

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Active Smoking is Associated with Lower Dialysis Adequacy in Prevalent Dialysis Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.851 ◽

2019 ◽

Vol 7 (21) ◽

pp. 3615-3618

Author(s):

Lada Trajceska ◽

Gjulsen Selim ◽

Marija Zdraveska ◽

Deska Dimitrievska ◽

Daniela Mladenovska ◽

...

Keyword(s):

Clinical Laboratory ◽

Smoking Status ◽

Reduction Rate ◽

Cross Sectional Study ◽

Dialysis Session ◽

Active Smoking ◽

Dialysis Patients ◽

Dialysis Adequacy ◽

Cross Sectional ◽

Dialysis Vintage

BACKGROUND: Dialysis adequacy measured by single pool Kt/V (spKt/V) lower than 1.2 or urea reduction rate (URR) lower than 65% is associated with a significant increase in patient mortality rate. Patients’ adherence to the medical treatment is crucial to achieve recommended targets for spKt/V. Smoking is a recognized factor of non-adherence. AIM: In this study we sought to assess the association of active smoking and dialysis adequacy. METHODS: A total of 134 prevalent dialysis patients from one dialysis center were included in an observational cross-sectional study. Clinical, laboratory and dialysis data were obtained from medical charts in previous 6 months. The number of missed, on purpose interrupted or prematurely terminated dialysis sessions was obtained. Dialysis adequacy was calculated as spKt/V and URR. Patients were questioned about current active smoking status. T-test and Chi-Square test were used for comparative analysis of dialysis adequacy with regard to smoking status. RESULTS: The majority of patients declared a non-smoking status (100 (75%)) and 34 (25%) were active smokers. Male gender, younger age and shorter dialysis vintage were significantly more often present in the active smokers ((9 (26%) vs 25 (73%), p = 0.028; 57.26 ± 12.59 vs 50.15 ± 14.10, p = 0.012; 118.59 ± 76.25 vs 88.82 ± 57.63, p = 0.030)), respectively. spKt/V and URR were significantly lower and Kt/V target was less frequently achieved in smokers ((1.46 ± 0.19 vs. 1.30 ± 0.021, p = 0.019; 67.14 ± 5.86 vs. 63.64 ± 8.30, p = 0.002; 14 (14%) vs. 11 (32%), p = 0.023), respectively. Shorter dialysis sessions, larger ultra filtrations and higher percentage of missed/interrupted dialysis session on patients’ demand were observed in smokers (4.15 ± 0.30 vs. 4.05 ± 0.17, p = 0.019; 3.10 ± 0.78 vs. 3.54 ± 0.92, p = 0.017; 25 (0.3%) vs. 48 (1.8%), p = 0.031), respectively. CONCLUSION: Active smokers, especially younger men, achieve lower than the recommended levels for dialysis adequacy. Non-adherence to treatment prescription in smokers is a problem to be solved. Novel studies are recommended in patients on dialysis, to further elucidate the association of dialysis adequacy with the active smoking status.

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Predictors of protein-energy wasting in haemodialysis patients: a cross-sectional study

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12276 ◽

2014 ◽

Vol 29 (1) ◽

pp. 38-47 ◽

Cited By ~ 17

Author(s):

M. Ruperto ◽

F. J. Sánchez-Muniz ◽

G. Barril

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Protein Energy Wasting ◽

Cross Sectional ◽

Protein Energy

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Association of Growth Differentiation Factor 15 with Mortality in a Prospective Hemodialysis Cohort

Cardiorenal Medicine ◽

10.1159/000455907 ◽

2017 ◽

Vol 7 (2) ◽

pp. 158-168 ◽

Cited By ~ 10

Author(s):

Amy S. You ◽

Kamyar Kalantar-Zadeh ◽

Lorena Lerner ◽

Tracy Nakata ◽

Nancy Lopez ◽

...

Keyword(s):

Cardiovascular Disease ◽

Mortality Risk ◽

Hemodialysis Patients ◽

Case Mix ◽

Dialysis Patients ◽

Protein Energy Wasting ◽

Growth Differentiation Factor 15 ◽

Differentiation Factor ◽

Protein Energy ◽

Dialysis Vintage

Background/Aims: Cardiovascular disease and protein-energy wasting are among the strongest predictors of the high mortality of dialysis patients. In the general population, the novel cardiovascular and wasting biomarker, growth differentiation factor 15 (GDF15), is associated with decreased survival. However, little is known about GDF15 in dialysis patients. Methods: Among prevalent hemodialysis patients participating in a prospective study (October 2011 to August 2015), we examined the association of baseline GDF15 levels with all-cause mortality using unadjusted and case mix-adjusted death hazard ratios (HRs) that controlled for age, sex, race, ethnicity, diabetes, and dialysis vintage. Results: The mean age ± SD of the 203 patients included in the study was 53.2 ± 14.5 years, and the cohort included 41% females, 34% African-Americans, and 48% Hispanics. GDF15 levels (mean ± SD 5.94 ± 3.90 ng/mL; range 1.58-39.8 ng/mL) were higher among older patients and were inversely associated with serum creatinine concentrations as a surrogate for muscle mass. Each 1.0 ng/mL increase in GDF15 was associated with an approximately 17-18% higher mortality risk in the unadjusted and case mix models (p < 0.05). Increments of about 1 SD (a 4.0 ng/mL increase in GDF15) were associated with a nearly 2-fold higher death risk. The highest GDF15 tertile was associated with higher mortality risk (reference: lowest tertile): the HRs (95% CI) were 3.19 (1.35-7.55) and 2.45 (1.00-6.00) in the unadjusted and the case mix-adjusted model, respectively. These incremental death trends were confirmed in cubic spline models. Conclusion: Higher circulating GDF15 levels are associated with higher mortality risk in hemodialysis patients. Future studies are needed to determine whether GDF15 may represent a novel therapeutic target for cardiovascular disease, wasting, and death in this population.

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Factors associated with nutritional status, knowledge and attitudes among tuberculosis patients receiving treatment in Ghana: A cross-sectional study in the Tema Metropolis

PLoS ONE ◽

10.1371/journal.pone.0258033 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258033

Author(s):

Prince Kubi Appiah ◽

Bright Osei ◽

Hubert Amu

Keyword(s):

Nutritional Status ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

World Health ◽

Nutritional Deficiencies ◽

Nutritional Knowledge ◽

Cross Sectional ◽

Logistic Regression Models ◽

Knowledge And Attitudes ◽

Increased Risk

Background Nutritional deficiencies are generally associated with increased risk and severity of tuberculosis. This study investigated the nutritional status, knowledge, and attitudes of tuberculosis (TB) patients receiving treatment in the Tema Metropolis. Method A cross-sectional design was used to collect data on the nutritional knowledge, attitude, and status of TB patients. Nutritional status was analysed using World Health Organization’s formula for body mass index. Pearson’s chi-square and logistic regression models were used to assess associations between predictor and outcome variables. All statistical analyses were considered significant at p-values < 0.05. Result The prevalence of malnutrition among TB patients was 39.7%, 14.4%, and 4.8% for underweight, overweight, and obesity respectively. There was a high (61.0%) knowledge of nutrition among the patients. Also, 65.8% had good attitude towards nutrition. There were significant associations between normal nutritional status and age of the TB patients (p = 0.041), highest educational level attained (p = 0.036), employment status (p = 0.019), status of alcohol intake (p = 0.031), number of months on TB treatment (p = 0.021), and attitude towards nutrition (p = 0.028). Conclusion There was a reasonable nutrition-related knowledge and attitude towards nutrition among the TB patients. However, that did not reflect on their nutritional status. We recommend continuing education on smoking cessation, avoidance of harmful use of alcohol, and the establishment of food aid and other livelihood intervention programs for TB patients.

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Quality and adequacy of sleep among dialysis patients

Biomedicine ◽

10.51248/.v40i4.338 ◽

2021 ◽

Vol 40 (4) ◽

pp. 543-546

Author(s):

V. Daniel ◽

S. Meetha ◽

M. Jayakumar ◽

Manikantan Sekar

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Dialysis Patients ◽

Cross Sectional ◽

Increased Risk ◽

Dialysis Vintage ◽

Psychosocial Disability

Introduction and Aim: Chronic Kidney Disease (CKD) is a debilitating illness characterized by physical, mental, socioeconomic and psychosocial disability. Being a literature has documented evidences of increased risk of depression and sleep disturbances among these patients, which indirectly affect the quality of life. The present study was carried out to evaluate the burden of depression and sleep disturbances among dialysis patients. Methods: This cross-sectional study was carried out among 160 patients on maintenance dialysis. A structured proforma was used to document the particulars regarding CKD care. Sleep Quality, Depression status of patients were assessed using Pittsburgh Sleep Quality Index (PSQI), Beck’s Depression Inventory (BDI) and Kt/V formula respectively. Results: Hemodialysis inadequacy was prevalent among 79.4% of the participants. About 51.3% were suffering from moderate depression. Severe sleep disturbance was seen in 88.7% of the participants. The present study observed a statistically significant association between dialysis vintage and depression (p<0.05). Similar association was seen between frequency of dialysis and sleep disturbances (p<0.05). Conclusion: The prevalence of sleep disturbances and depression was higher among the maintenance hemodialysis patients receiving dialysis for more than 2 years and also with a frequency of twice a week. It may be inferred that by increasingthe frequency and the dosage of dialysis in patients the quality of sleep can be adequately improved and thereby it may lower the depressive state in patients.

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The association between nutritional status and functional limitations among centenarians: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02312-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yang Song ◽

Miao Liu ◽

Wang-ping Jia ◽

Ke Han ◽

Sheng-shu Wang ◽

...

Keyword(s):

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Functional Limitations ◽

Mini Nutritional Assessment ◽

Disease Status ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models

Abstract Background Although there have been studies on the association between nutritional status and functional limitations, there were few studies on Asian centenarians in community. Therefore, this study aims to identify associations between nutritional status and functional limitations among centenarians in China. Methods This cross-sectional study was conducted with the data from the China Hainan Centenarian Cohort Study. These data ultimately included basic characteristics, hematologic indicators, and chronic disease status for 1,002 centenarians. The nutritional status was evaluated using the Mini Nutritional Assessment Short-Form scale. The functional limitations were assessed using the activities of daily living (ADL) scale, namely Barthel Index and Lawton Scale. The association between nutritional status and ADL was assessed using multivariate logistic regression models. Results In this study, the prevalence of malnutrition was 20.8 % among centenarians, basic ADL (BADL) limitation was 28.6 %, and instrumental ADL (IADL) limitation was 64.7 %. As the nutritional status deteriorated, the risk of ADL limitations increased in total population (BADL limitation: OR = 17.060, 95 % CI: 8.093-35.964; IADL limitation: OR = 11.221, 95 % CI: 5.853-21.511; p for trend < 0.001). Similar results were found in both men and women after stratifying sex but were more prominent in women. Conclusions Malnutrition is associated with functional limitations among centenarians in China and more pronounced among women.

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