scholarly journals Peritoneal Protein Loss Is Not Associated With Sarcopenia in Peritoneal Dialysis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Jun Young Do ◽  
A Young Kim ◽  
Seok Hui Kang

Introduction: Maintenance of a peritoneal membrane is essential for maintaining long-term peritoneal dialysis (PD). Peritoneal protein loss (PPL) is basically the loss of an essential nutrient, which may lead to malnutrition. We aimed to evaluate the association between PPL and sarcopenia in PD patients.Methods: We conducted a cross-sectional study from September 2017 to November 2020 on all PD patients (n = 199). Finally, the patients were divided into tertiles based on the PPL level as follows: low, middle, and high. PPL (mg/day), appendicular lean mass (ALM) using dual-energy X-ray absorptiometry, and handgrip strength (HGS) were evaluated. Sarcopenia was defined using cut-off values from the Asian Working Group for Sarcopenia.Results: The median PPL (interquartile range, interval) in the low, middle, and high tertiles were 4,229 (904, 1,706–5,111), 6,160 (760, 5,118–7,119), and 8,543 (2,284, 7,145–24,406) mg/day, respectively. HGS in the low, middle, and high tertiles was 23.4 ± 9.2, 23.8 ± 8.9, and 23.6 ± 8.3 kg, respectively (P = 0.967). The ALM index in the low, middle, and high tertiles was 6.0 ± 1.3, 6.0 ± 1.2, and 6.5 ± 1.1 kg/m2, respectively (P = 0.061). Multivariate analyses did not reveal significant differences in HGS and ALM index in among tertiles. The proportions of patients with sarcopenia in the low, middle, and high tertiles was 24 (36.4%), 19 (28.4%), and 21 (31.8%), respectively (P = 0.612).Conclusion: The present study showed that PPL is not independently associated with muscle mass, strength, and sarcopenia in PD patients.

Author(s):  
Wander Valadares de Oliveira Júnior ◽  
Sylvia Dias Turani ◽  
Maria Aparecida Silva Marinho ◽  
Sérgio Wyton Lima Pinto ◽  
Alba Otoni ◽  
...  

Abstract Introduction: Progressive structural changes in the peritoneal membrane occur over the course of treatment in peritoneal dialysis (PD), resulting in an increase in cytokines such as CCL2 and structural changes in peritoneal membrane triggering an increase in CA-125 in dialysate, which reflects a probable local inflammatory process, with possible loss of mesothelial cells. Thus, the current study aimed to evaluate the association between plasma and CCL2 and CA-125 dialysate levels in patients undergoing PD. Methods: Cross-sectional study was conducted with 41 patients undergoing PD. The assessments of CA-125 and CCL2 levels were performed using a capture ELISA. Correlations were estimated using Spearman's correlation and the investigation of the association between the explanatory variables (CCL2) and response variable (CA-125) was done for crude ratio of arithmetic means and adjusted utilizing generalized linear models. Results: A moderate positive correlation was observed between the levels of CA-125 and CCL2 in the dialysate (rho = 0.696). A statistically significant association was found between the levels in the CCL2 and CA-125 dialysate (RoM=1.31; CI = 1.20-1.43), which remained after adjustment for age (RoM = 1.31; CI=1.19-1.44) and for time in months of PD (RoM=1.34, CI=1.22-1.48). Conclusion: The association of CA-125 levels with CCL2 in the dialysate may indicate that the local inflammatory process leads to temporary or definitive changes in peritoneal membrane. A better understanding of this pathogenesis could contribute to the discovery of new inflammatory biomarkers.


Nephron Extra ◽  
2015 ◽  
Vol 5 (3) ◽  
pp. 79-86 ◽  
Author(s):  
Takashi Hara ◽  
Hideyuki Mukai ◽  
Takafumi Nakashima ◽  
Rikako Sagara ◽  
Masahide Furusho ◽  
...  

2015 ◽  
pp. 50-58
Author(s):  
Thi Dung Nguyen ◽  
Tam Vo

Background: The patients on hemodialysis have a significantly decreased quality of life. One of many problems which reduce the quality of life and increase the mortality in these patients is osteoporosis and osteoporosis associated fractures. Objectives: To assess the bone density of those on hemodialysis by dual energy X ray absorptiometry and to examine the risk factors of bone density reduction in these patients. Patients and Method: This is a cross-sectional study, including 93 patients on chronic hemodialysis at the department of Hemodialysis at Cho Ray Hospital. Results: Mean bone densities at the region of interest (ROI) neck, trochanter, Ward triangle, intertrochanter and total neck are 0.603 ± 0.105; 0.583 ± 0.121; 0.811 ± 0.166; 0.489 ± 0.146; 0.723 ± 0.138 g/cm2 respectively. The prevalences of osteoporosis at those ROI are 39.8%, 15.1%; 28%; 38.7%; and 26.9% respectively. The prevalences of osteopenia at those ROI are 54.8%; 46.3%; 60.2%; 45.2% and 62.7% respectively. The prevalence of osteopososis in at least one ROI is 52.7% and the prevalence of osteopenia in at least one ROI is 47.3%. There are relations between the bone density at the neck and the gender of the patient and the albuminemia. Bone density at the trochanter is influenced by gender, albuminemia, calcemia and phosphoremia. Bone density at the intertrochanter is affected by the gender. Bone density at the Ward triangle is influenced by age and albuminemia. Total neck bone density is influenced by gender, albuminemia and phosphoremia. Conclusion: Osteoporosis in patients on chronic hemodialysis is an issue that requires our attention. There are many interventionable risk factors of bone density decrease in these patients. Key words: Osteoporosis, DEXA, chronic renal failure, chronic hemodialysis


2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.


Author(s):  
Bum Jung Kim ◽  
Sun-young Lee

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.


2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Agnieszka Wiśniowska-Szurlej ◽  
Agnieszka Ćwirlej-Sozańska ◽  
Justyna Kilian ◽  
Natalia Wołoszyn ◽  
Bernard Sozański ◽  
...  

AbstractHandgrip strength (HGS) is used as a biomarker for the state of health of older people, but the number of research publications containing the normative values of HGS in older adult populations is limited. The aim of the study was to define reference values and factors associated with HGS in older adults living in southeastern Poland. A cross-sectional study including 405 participants aged 65 and older was conducted. Handgrip strength for the dominant hand was assessed by the average of three trials using a JAMAR dynamometer. The sample was categorized into the following age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, 85 and over. The average HGS was 19.98 kg (16.91 kg for women and 26.19 kg for men). There was a decrease in handgrip strength across the age range in both sexes. The average handgrip strength of the older people was 17.97 kg (14.47 kg for women and 25.66 kg for men) for those aged 80–85 and 16.68 kg (13.51 kg for women and 21.77 kg for men) in the group over 85 years old. In both sexes, marital status was an independent factor associated with reduced handgrip strength. In conclusion, this study described, for the first time, handgrip strength values for the southeastern Polish population aged ≥ 65 years according to age and gender.


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