The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients

2021 ◽  
pp. CJN.16821020
Author(s):  
Yaya Yang ◽  
Xianhui Qin ◽  
Junzhi Chen ◽  
Qi Wang ◽  
Yaozhong Kong ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Nutritional Supplement ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Dietary Energy ◽  
Short Term ◽  
Dietary Energy Intake

Background and objectives: Fat-based energy-dense nutritional supplements may offer benefits over protein or carbohydrate dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake. Design, setting, participants, and measurements: We enrolled nondiabetic patients receiving hemodialysis for more than 3 months and had inadequate dietary energy intake (<30kcal/kg/d). The participants were randomly assigned in a 1:1 ratio to receive an oral fat-based energy-dense supplement (300kcal daily) or routine care for 12 weeks (n=120 per group). The primary outcome was the change in phase angle, measured by bioelectrical impedance analysis, a marker of cell integrity and body cell mass, from the baseline to week 12. The secondary outcomes were changes in quality of life. Other outcomes included laboratory nutritional indicators and physical examinations. Results: The average age of the total population was 47 (SD: 12) years and 55% were male. The median of dialysis vintage was 43.4 (22.5, 76.3) months. 240 participants were randomly assigned to the intervention (n=120) or control group (n=120). In total, 228 (95%) participants completed the trial. The change in phase angle did not differ significantly between the intervention and the control groups (estimate (95% confidence interval [CI]): 0.0 (-0.1, 0.1) vs. 0.0 (-0.1, 0.1); estimated difference, 0.0; 95% [CI], −0.2 to 0.2; P=0.99). None of the 19 domains of quality of life differed between the groups. Adverse events were reported in 23 (19%) participants in the control group and 40 (33%) participants in the intervention group. Conclusions: In nondiabetic maintenance hemodialysis patients, short-term administration of fat-based energy-dense nutritional supplement has no clinically significant effect on nutritional status as measured by phase angle.

The Influence of SDM-Based Individualized Management Model on the Health Outcome and Quality of Life of Maintenance Hemodialysis Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 1480-1487
Author(s):  
Haiyan Liu ◽  
He Qin ◽  
Lihui Shao
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Kidney Disease ◽  
Hemodialysis Patients ◽  
Self Management ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Observation Group ◽  
Individualized Management

Background Chronic kidney disease is a common clinical problem that endangers human physical and mental health and life safety. It eventually evolves into end-stage renal disease, and the incidence has increased year by year. It has been reported that the incidence of chronic kidney disease in China is about 10 %, and most patients need to carry out dialysis to maintain life. Objective To observe the influence of an individualized management model based on shared decision-making (SDM) between doctors, nurses and patients on the health outcomes and quality of life of maintenance hemodialysis patients. Methods A total of 100 end-stage renal disease patients treated with maintenance hemodialysis intervention in the Department of Nephrology, Changyisha City Fourth Hospital from May 2020 to May2021 were selected. According to the order of admission, they were randomly divided into control groups (n=50)) And the observation group (n=50). The control group received conventional management mode intervention, and the observation group received SDM-based individualized management mode intervention. The blood pressure and fluid control of the two groups were recorded, and the self-management behavior scale for hemodialysis patients (SMSH), the satisfaction survey questionnaire for patient participation in medical decision-making, and the kidney disease-related quality of life scale (KDTA) were used to evaluate the self-management ability of the two groups. Satisfaction and quality of life. Results After the intervention, fluid intake, weight gain between dialysis intervals, and the number of dialysis-related complications in the observation group decreased significantly (P<0.05), while the number of dialysis-related complications in the control group decreased (P<0.05), but fluid The intake and weight gain between dialysis intervals were similar to those before the intervention (P>0.05), and the fluid control in the observation group improved more significantly than the control group after the intervention (P<0.05). After the intervention, the systolic and diastolic blood pressure of the observation group decreased significantly (P<0.05), and the systolic and diastolic blood pressure of the control group were similar to those before the intervention (P>0.05). The blood pressure of the observation group improved more significantly than the control group after the intervention (P<0.05). After the intervention, the two groups of SMSH scale scores (problem solving, self-care, partnership, emotional processing, etc.), satisfaction scores (information, communication and negotiation, decision-making, total satisfaction and confidence, etc.), quality of life scores (symptoms, kidney disease, etc.) The impact of kidney disease, the burden of kidney disease, work status, cognitive function, social quality, sleep, social support, etc.) have been greatly improved (P<0.05), and the SMSH scale score, satisfaction score, quality of life of the observation group after intervention The score improved more significantly than the control group (P<0.05). Conclusion Intervention of maintenance hemodialysis patients based on an individualized management model of SDM can improve the self-management ability and satisfaction of patients, improve the quality of life, and reduce the occurrence of adverse events and complications.

scholarly journals P0948ASSOCIATION OF PHASE ANGLE WITH NUTRITION, MORTALITY, MAJOR ADVERSE CARDIOVASCULAR EVENTS AND SARCOPENIA IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Lower Phase ◽  
All Cause Mortality ◽  
History Of ◽  
Maintenance Hemodialysis Patients

Abstract Background and Aims Nutrition has been consistently important in end stage renal disease patients. However, it is difficult to obtain adequate nutritional status while avoiding fluid overload, hyperphosphatemia and hyperkalemia in hemodialysis patients. In addition, there is no golden standard for diagnosing protein energy wasting (PEW) in maintenance hemodialysis patients. We studied the clinical significance of phase angle using bioelectrical impedance analysis (BIA), one of the PEW diagnostic tools, to predict various clinical outcomes in maintenance hemodialysis patients. Method We retrospectively enrolled patients who received hemodialysis for more than 3 months from 2016 to March 2019, excluding patients had active cancer, or died within 30 days, had no BIA data. We evaluated the factors related phase angle and the role of phase angle as predictors of all-cause mortality and major adverse cardiovascular events (MACE), sarcopenia. Results Of 191 patients, 63.4% were men, mean age was 64.2 ± 12.4 years, mean body mass index (BMI) was 23.8 ± 6.9 kg/m2, and the most common underlying disease were hypertension and diabetes mellitus. Lower phase angle group (phase angle ≤4°) patients had older age, higher portion of women, malnourished, and history of coronary artery disease (CAD) than higher phase angle group (phase angle &gt;4°) patients. Phase was significantly related with nutritional parameters. During a median follow up of 16.7 months, 14.1% (n=27) patients experienced a MACE, 11.0% (n=21) patients died. In multivariate Cox analyses, lower phase angle, higher CRP level and history of CAD were significantly related with all-cause mortality even after adjustment for covariates. However, phase angle was not significantly associated with MACE and sarcopenia. Conclusion In maintenance hemodialysis patients, phase angle was significantly related to mortality as well as nutritional status, but MACE and sarcopenia were not. Clinicians should be careful to find and treat correctable factors with low phase angle and high CRP level in maintenance hemodialysis patients.

Penatalaksanaan IMD pada Ibu Postpartum Sectio Caesarea Mempengaruhi Status Gizi dan Kecepatan Produksi ASI

2020 ◽  
Vol 2 (2) ◽  
pp. 112-120
Author(s):  
Nursari Abdul Syukur ◽  
Susi Purwanti
Keyword(s):  
Breast Milk ◽  
Nutritional Status ◽  
Milk Production ◽  
Quantitative Research ◽  
Milk Protein ◽  
Sectio Caesarea ◽  
Control Group ◽  
P Value ◽  
Study Results

Many mothers who give birth to Sectio Caesarea (SC) do not Initiate Early Breastfeeding (IMD), which fails exclusive breastfeeding. This study aimed to determine the effect of IMD management in postpartum SC mothers on nutritional status, speed of milk production, and quality of breast milk protein. Method: quantitative research with quasi approach experiment. The research design used was a pre-post-test control non-equivalent control group. A sampling of this study used the Consecutive method sampling with a sample of 20 mothers who gave birth by cesarean section (SC). Hypothesis testing uses the independent t-test and the Mann-Whitney test. The study results showed an influence on the management of IMD in postpartum SC mothers on the speed of ASI production (p-value=0.004) and nutritional status (p-value=0.028). There was no effect of IMD management on postpartum SC mothers on the quality of breast milk protein (p-value = 0.543). This study recommends that the hospital implement an IMD promotion program before the abdominal wall is closed as a form of intervention to increase milk production and maternal nutritional status

L-carnitine infusions may suppress serum C-reactive protein and improve nutritional status in maintenance hemodialysis patients

2005 ◽  
Vol 15 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Vincenzo Savica ◽  
Domenico Santoro ◽  
Giampiero Mazzaglia ◽  
Franco Ciolino ◽  
Paolo Monardo ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Maintenance Hemodialysis Patients

Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Practical Method ◽  
Hemodialysis Patients ◽  
Normal Weight ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Subjective Global Assessment ◽  
Cross Sectional

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...

MO894EVALUATIONS OF TOXIC HEAVY METALS LEAD AND MERCURY IN REGULAR HEMODIALYSIS SMOKER AND NONSMOKER PATIENTS BY COMPARISON WITH OTHER HEALTHY CONTROL SUBJECTS IN EGYPTIAN POPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ezzeldin Shalaby ◽  
Hisham Abdelmawgoud
Keyword(s):  
Heavy Metals ◽  
Kidney Diseases ◽  
Mercury Level ◽  
Lead Level ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Toxic Heavy Metals ◽  
Ckd Stage ◽  
Regular Hemodialysis

Abstract Background and Aims Around worldwide population, 10% are affected by chronic kidney diseases (CKD); hemodialysis is the common choice of renal replacement therapy. Cigarette smokers have higher Lead level than non-smoker population. As Tobacco leaves are grown on polluted soil, it is proven that Mercury poisoning depends on dose and duration of exposure. Aim of the study was to determine two important toxic heavy metals elements Lead and Mercury concentrations in regular hemodialysis patients smoker and non-smoker by comparison with normal subjects and its correlation to anemia. Method Blood samples were collected from CKD patients on maintenance hemodialysis for more than 6 months divided into non-smoker and smoker to be compared with samples from a control group of non-CKD, non-smoker persons. This study was conducted in September 2019 in Al Mokattam Insurance Hospital – Cairo and involved 60 persons of both sex. They were divided into 3 groups: CKD stage 5 patients on hemodialysis 40 patients and sub-divided into 2 groups; (smoker) 20 patients and (non-smoker) 20 patients and the history of eating fish and seafood was taken. The third group was a control group included 20 healthy non-smoker participants. Lead and Mercury were analyzed by electro thermal atomic absorption spectrophotometer in Al Borg central Laboratory. The complete blood count (CBC), kidney function tests and Iron parameters were also detected. Results duration on hemodialysis did not raise Lead or Mercury level in blood, while smoking raises Lead level in blood, and eating fish and sea food more than once per week increased Mercury level in blood. There was a relation between raised Lead level and anaemia in hemodialysis patients. Conclusion Lead Prolonged and Mercury measurement is important in hemodialysis patients with possible symptoms of heavy metal toxicity. Lead level monitoring is recommended in resistant anemia in hemodialysis patients.

scholarly journals Effect of energy intake on nutritional status in maintenance hemodialysis patients

1989 ◽  
Vol 35 (2) ◽  
pp. 704-711 ◽  
Author(s):  
Larry A. Slomowitz ◽  
Francisco J. Monteon ◽  
Mary Grosvenor ◽  
Steward A. Laidlaw ◽  
Joel D. Koppel
Keyword(s):  
Nutritional Status ◽  
Energy Intake ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients
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