scholarly journals Nutritional Guideline for the Management of Mexican Patients with CKD and Hyperphosphatemia

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3289 ◽  
Author(s):  
Frida Palafox-Serdán ◽  
Olinto A. Luna-Montiel ◽  
Sebastián E. Pablo-Franco ◽  
Daniela L. Guillen-Tejada ◽  
Sandra D. Carreño-Vázquez ◽  
...  
Keyword(s):  
Cultural Context ◽  
Metabolic Disorders ◽  
Phosphorus Content ◽  
Phosphate Binders ◽  
Nutritional Management ◽  
Protein Ratio ◽  
Nutritional Interventions ◽  
Phosphate Intake ◽  
Control Serum ◽  
High Prevalence

Chronic kidney disease (CKD) represents a serious concern for the Mexican population since the main predisposing diseases (diabetes, hypertension, etc.) have a high prevalence in the country. The development of frequent comorbidities during CKD such as anemia, metabolic disorders, and hyperphosphatemia increases the costs, symptoms, and death risks of the patients. Hyperphosphatemia is likely the only CKD comorbidity in which pharmaceutical options are restricted to phosphate binders and where nutritional management seems to play an important role for the improvement of biochemical and clinical parameters. Nutritional interventions aiming to control serum phosphate levels need to be based on food tables, which should be specifically elaborated for the cultural context of each population. Until now, there are no available food charts compiling a high amount of Mexican foods and describing phosphorus content as well as the phosphate to protein ratio for nutritional management of hyperphosphatemia in CKD. In this work, we elaborate a highly complete food chart as a reference for Mexican clinicians and include charts of additives and drug phosphate contents to consider extra sources of inorganic phosphate intake. We aim to provide an easy guideline to contribute to the implementation of more nutritional interventions focusing on this population in the country.

scholarly journals Asupan protein dan fosfor, rasio fosfor-protein, dan kadar fosfor darah pada pasien gagal ginjal kronis dengan hemodialisis

2012 ◽  
Vol 9 (2) ◽  
pp. 58
Author(s):  
Ahmad Syauqy ◽  
Susetyowati . ◽  
Suhardi .
Keyword(s):  
Protein Intake ◽  
Mineral Metabolism ◽  
Serum Phosphate ◽  
High Protein ◽  
Phosphate Level ◽  
Phosphate Binders ◽  
Serum Phosphate Level ◽  
Protein Ratio ◽  
Phosphate Intake ◽  
High Phosphate

Background: Hyperphosphatemia has become one of the main causes of death in CKD patients on HD. Thus, correction and prevention of hyperphospatemia is a major component in the management of HD patients. High protein diet in HD patients may lead to increased serum phosphate level due to mineral metabolism disorder associated with decreased glomerular filtration rate. In addition, high protein intake often followed by high phosphate intake as high protein foods also contains high phosphate and may cause hyperphosphatemia. Meanwhile, reduction of protein intake to control phosphate level was associated with decreased health and nutritional status in CKD patients. Therefore, appropriate phosphate-protein ratio is essential to provide adequate protein intake and avoid hyperphosphatemia.Objective: To investigate the association between protein and phosphate intake, phosphate-protein ratio and blood phosphate level in CKD patients on routine HD.Method: The study used an analytic observational method with cross sectional design. There were 100 subjects involved in this study. Subject characteristics, protein and phosphate intake, phosphate-protein ratio and intake of phosphate binders were obtained through interview and 3 x24 hour food record. Serum phosphate level was analyzed by inorganic phosphorus quantification method. Food processor was used to analyze the intake of protein and phosphate. Bivariate and multivariate tests with 95% confidence interval were used to analyze the data.Results: Adequate protein intake was observed among 38% subjects, while 46% of them have excess phosphate intake.High phosphate-protein ratio was found in 20% subjects. Most subjects did not take phosphate binders regularly (61%) and have hyperphosphatemia (66%). The average protein intake, phosphate intake, phosphate-protein ratio, and blood phosphate level were 1.1 g/kg/d, 13.5 mg/kg/d, 12.8 mg/g, and 5.6 mg/dl, respectively. Bivariate test showed that there was a significant association between protein intake (p=0.037; RP=2.78), phosphate intake (p=0.005; RP=3.54), phosphate-protein ratio (p=0.045; RP=3.85), and blood phosphate level in CKD patients on routine HD. Multivariate analysis revealed that high phosphate intake and did not consume phosphate binders regularly  were risk factors of hyperphosphatemia (p=0.000; OR=6.543; CI 95%:2.357-18.164 dan p=0.024; OR=3.413; CI 95%:1.179; R2=0.42).Conclusion: Consumtion of low phosphate foods and phosphate binders may reduce the risk of hyperphosphatemia in CKD patients on routine HD.

Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

2015 ◽  
Vol 85 (3-4) ◽  
pp. 129-144 ◽  
Author(s):  
Zahra Heidari ◽  
Awat Feizi ◽  
Leila Azadbakht ◽  
Nizal Sarrafzadegan
Keyword(s):  
At Risk ◽  
National Cancer Institute ◽  
Population Based ◽  
Cross Sectional Study ◽  
Normal Function ◽  
Dietary Intakes ◽  
Middle Aged ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
High Prevalence

Abstract. Background: Minerals are required for the body’s normal function. Aim: The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. Methods: In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). Results: There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Conclusion: Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

scholarly journals A Qualitative Content Analysis of Cardiovascular Diseases Related Health Information Targeted at the Hui Minority on Chinese WeChat Official Accounts

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1359
Author(s):  
Lei Yang ◽  
Yuping Mao ◽  
Jeroen Jansz
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cultural Context ◽  
Qualitative Content Analysis ◽  
Qualitative Approach ◽  
Exploratory Research ◽  
Healthy Life ◽  
High Prevalence ◽  
Minority People

In this study, we focus on the information available in WeChat official accounts about cardiovascular diseases (CVDs), which are a leading cause of death in China. We are particularly interested in information targeting the Chinese Hui minority people, who have a high prevalence of cardiovascular risk factors (CVRFs). Our exploratory research therefore investigates whether and how the articles on WeChat official accounts are targeted at the Hui people. We used a qualitative approach to analyze 108 articles. Two related themes emerged: descriptions of how to live a healthy life; and explanations of CVDs and CVRFs. Traditional Chinese medicine likewise surfaced from the analysis as a specific and unique theme in the Chinese social and cultural context. Despite the high prevalence of CVRFs among the Hui, none of the articles included information tailored to them.

Renal Osteodystrophy and the Status of Aluminum and Other Trace Metals in CAPD Patients: A Panel Review

1984 ◽  
Vol 4 (3) ◽  
pp. 129-136 ◽  
Author(s):  
Vito Campese ◽  
Ronald E. Easterling ◽  
Fred Finkelstein ◽  
William Mattern ◽  
David A. Ogden ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Disease ◽  
Phosphorus Removal ◽  
Aluminum Toxicity ◽  
Phosphate Binders ◽  
Total Serum ◽  
Hypertonic Solutions ◽  
Total Serum Calcium ◽  
Control Serum ◽  
Panel Review

Most reports indicate that in patients on CAPD, hyperparathyroid bone disease progresses, while osteomalacia improves. With 1.5g% Dianeal, and when dialysate Ca is 7mg%, peritoneal mass transfer of calcium is positive, i.e., it is absorbed from the solution, while with hypertonic solutions it is less positive or even negative. Daily phosphorus removal by CAPD is insufficient to control serum phosphorus, hence CAPD patients require phosphate binders and/or phosphate restriction. Peritoneal phosphorus removal is greater with hypertonic than with isotonic solutions. In patients on CAPD, the loss of substantial amounts of D-binding protein and 25(OH)DJ into the dialysate, produces a gradual decrease in plasma 25(OH)D levels. Similarly, these patients have low 1,25(OH)D2 DJ levels and, hence, should receive vitamin D or its analogues. Unlike hemodialysis, CAPD results in a significant removal of PTH, with a peritoneal clearance of 1.5 ml/min. However, despite an estimated daily loss of 13.5% of the circulating PTH, there probably is not a significant effect on plasma PTH levels, which usually respond to changes in serum Ca. Levels of the intact PTH molecule provide a better index of hyperparathyroidism than do levels of its COOH-terminal fragment. With regard to investigation and treatment, one should measure serum ionic calcium rather than total calcium, even if the latter is corrected for total protein. The minimal dialysate calcium should be 7 mg/dl and for hypertonic solutions, perhaps it should be higher (7.5–8.0 mg%). Total serum calcium should be maintained at 10.2–10.7 mg/dl (ionized calcium of 5.1–5.5 mg/dl); adjunctive use of active forms of vitamin D and prevention of aluminum intoxication may prevent progressive bone disease in CAPD, and existing bone disease may heal. Whereas there are enough data supporting the connection of aluminum toxicity and osteomalacia in hemodialysis patients, data concerning the incidence of osteomalacia and its relationship to aluminum in CAPD patients are scarce. Apparently CAPD removes aluminum more efficiently than hemodialysis. CAPD patients are less likely to develop osteomalacia because the dialysate aluminum content is low and these patients tend to require lower doses of phosphate binder. There are no extensive studies on trace element deficiencies or excess in patients on CAPD. These patients may be more susceptible to deficiencies of trace elements which are protein bound. Desferoxamine may be effectively used for the treatment of patients with either aluminum or iron overload.

scholarly journals Nonalcoholic steatohepatitis in posttransplantation liver: Review article

2018 ◽  
Vol 64 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Antônio Ricardo Cardia Ferraz de Andrade ◽  
Helma P. Cotrim ◽  
Paulo L. Bittencourt ◽  
Carolina G. Almeida ◽  
Ney Christian Amaral Boa Sorte
Keyword(s):  
Nonalcoholic Steatohepatitis ◽  
Clinical Characteristics ◽  
Metabolic Disorders ◽  
Patient Survival ◽  
De Novo ◽  
Review Article ◽  
Liver Transplants ◽  
The Third ◽  
High Prevalence ◽  
The World

Summary Introduction: Nonalcoholic steatohepatitis (NASH) associated or not with cirrhosis is the third leading indication for liver transplantation (LT) around the world. After transplants, NASH has a high prevalence and occurs as both recurrent and de novo manifestations. De novo NASH can also occur in allografts of patients transplanted for non-NASH liver disease. Objective: To evaluate recurrent or de novo NASH in post-LT patients. Method: A literature review was performed using search engines of indexed scientific material, including Medline (by PubMed), Scielo and Lilacs, to identify articles published in Portuguese and English until August 2016. Eligible studies included: place and year of publication, prevalence, clinical characteristics, risk factors and survival. Results: A total of 110 articles were identified and 63 were selected. Most of the studies evaluated recurrence and survival after LT. Survival reached 90-100% in 1 year and 52-100% in 5 years. Recurrence of NAFLD (steatosis) was described in 15-100% and NASH, in 4-71%. NAFLD and de novo NASH were observed in 18-67% and 3-17%, respectively. Metabolic syndrome, diabetes mellitus, dyslipidemia and hypertension were seen in 45-58%, 18-59%, 25-66% and 52-82%, respectively. Conclusion: After liver transplants, patients present a high prevalence of recurrent and de novo NASH. They also show a high frequence of metabolic disorders. Nevertheless, these alterations seem not to influence patient survival.

scholarly journals Perspectives on the Nutritional Management of Metabolic Syndrome in Asia: People, Practice and Programmes

2017 ◽  
Vol 24 (1) ◽  
pp. 65-70
Author(s):  
Chee Huei Phing
Keyword(s):  
Metabolic Syndrome ◽  
Ethnic Diversity ◽  
Active Role ◽  
Nutritional Management ◽  
Asian Countries ◽  
Optimal Care ◽  
The Metabolic Syndrome ◽  
Care Processes ◽  
High Prevalence ◽  
Large Populations

AbstractNumerous Asian countries have a high prevalence of metabolic syndrome, also associated with cardiovascular disease and diabetes mellitus. Healthcare expenditure varies among Asian countries, and is influenced by poverty factor and large populations. The effect of metabolic syndrome on nutritional management in Asia demonstrates the essential for clinicians to equalize the needs for higher standards of dietetics practice; as they execute optimal care processes with the aim of improving outcomes, alongside setting of workforce limitations, inadequate expertise in metabolic syndrome nutrition practice, as well as ethnic diversity among Asians. This paper presents some aspects of dietetics practice and the possibility that an alteration in practice is mandatory if dietitians are to play an active role in preventing or decelerating the evolution of the metabolic syndrome.

scholarly journals Metabolic diseases in cattle

2021 ◽  
pp. 184-189
Author(s):  
V. A. Mischenko ◽  
A. V. Mischenko ◽  
R. V. Yashin ◽  
V. A. Yevgrafova ◽  
T. B. Nikeshina
Keyword(s):  
Metabolic Disorders ◽  
Metabolic Diseases ◽  
Animal Health ◽  
Dairy Farming ◽  
Main Trend ◽  
Average Lifetime ◽  
Protein Ratio ◽  
High Productivity ◽  
Dairy Cattle Breeding ◽  
Immunodeficiency States

The main trend in the development of dairy farming in the Russian Federation suggests maximising milk yield and reducing milk net cost. The economic effectiveness of industrial dairy farming is largely determined by adequate feeding, as well as effective system of measures to ensure animal health and prevent infectious and non-infectious mass diseases. The main reason for the premature retirement of highly productive cows is based on the factors typical of the intensive technologies used in dairy cattle breeding, which lead to the occurrence of metabolic diseases. It is established that the intensity of metabolism is directly linked to the high productivity of cows. With a highly concentrated, mainly silage-based type of feeding, an imbalance of nutrients is often recorded, in particular as regards the sugar/ protein ratio, leading to deep metabolic disorders and the development of immunodeficiency states. Metabolic disorders in highly productive cows occur as a result of unbalanced diets as far as protein, carbohydrates, vitamins and minerals are concerned. Acidosis, ruminitis and hepatosis are recorded in disordered cows and heifers. The service period exceeds 100 days in 70–75% of cows. Hepatosis and immunodeficiency states are often found in calves born to cows with signs of deep metabolic disorders. Metabolic disorders often remain unnoticed and become apparent only when pronounced pathological changes occur resulting in decreased productivity and ability to reproduce resistant young animals, as well as culling of animals. Metabolic diseases were recorded in 30–70% of cows examined in large dairy farms. The average lifetime productivity of high-yielding cows is (2.1 ± 0.15) lactations in Russia. The results of epidemiological investigations and laboratory testing of sera samples showed that emulsion inactivated vaccines administered to immunodeficient cattle induce higher titres of virus-specific antibodies than those in animals vaccinated with adsorbed vaccines. 

scholarly journals Aldosterone- and cortisol-co-secreting adrenal tumors: an uneasy sum of well-known parts (review)

2019 ◽  
Vol 65 (2) ◽  
pp. 113-123
Author(s):  
Boris M. Shifman ◽  
Nadezhda M. Platonova ◽  
Natalya V. Molashenko ◽  
Ekaterina A. Troshina ◽  
Natalia Yu. Romanova ◽  
...  
Keyword(s):  
Metabolic Disorders ◽  
Cardiovascular Complications ◽  
Adrenal Tumors ◽  
Venous Sampling ◽  
Symptoms Of Depression ◽  
Peripheral Plasma ◽  
Increased Risk ◽  
High Prevalence ◽  
Potential Risks ◽  
Alternative Test

Primary aldosteronism (PA) is the most common form of secondary arterial hypertension. In patients with PA, more so than in the general population, there is a prevalence of insulin resistance, diabetes mellitus, metabolic syndrome, osteoporosis, and symptoms of depression; these conditions are more likely to manifest a gluco- rather than mineralocorticoid excess. This fact is of particular importance in light of recent studies that have shown that PA is often associated with glucocorticoid excess. Since the first reports of cases of combined secretion of aldosterone and cortisol in 1979, the number of cases of so-called Connshing syndrome has increased. An analysis of data from recent studies suggests that hypercortisolism in PA is closely associated with an increased risk of cardiovascular complications, metabolic disorders and post-surgical adrenal insufficiency. The most important diagnostic problem in adenomas with combined secretion is the risk of false interpretation of the results of adrenal venous sampling (AVS). The indications that suggest aldosterone-and-cortisol-co-producing adenoma are the lack of suppression of cortisol levels following a night test with 1mg of dexamethasone, and an adrenal tumo of over 2.5cm. As an alternative test capable of differentiating this type of tumor, a number of researchers have proposed measuring the level of so-called hybrid steroids in the peripheral plasma and urine. Taking into account the high prevalence and potential risks, ruling out of excess corisol secretion is obligatory in all cases of PA before AVS and when planning surgery.

Suicide in the Ukraine: Epidemiology, Knowledge, and Attitudes of the Population

Crisis ◽  
1996 ◽  
Vol 17 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Alexander Mokhovikov ◽  
Olga Donets
Keyword(s):  
Rural Areas ◽  
Cultural Context ◽  
Negative Influence ◽  
Social Psychological ◽  
Effective Prevention ◽  
Professional Groups ◽  
Knowledge And Attitudes ◽  
Completed Suicide ◽  
High Prevalence ◽  
Attitudes Towards Suicide

For several decades suicidology could not be discussed in the Ukraine, and so this is one of the first papers on suicide in this country. After a brief discussion of the epidemiology of suicide in the Ukraine, the authors present the results of research investigations on caregivers' knowledge about suicide, as well as an investigation of attitudes towards suicide. The principal conclusions are: 1. The frequency of suicide in the Ukraine is relatively high (24 per 100,000). The rate of suicide is much higher in rural areas than in the cities. The frequency of completed suicide is not the same in different regions of the country. 2. Sociopsychological processes in the post-totalitarian society have resulted in the development of the “Soviet syndrome” in the population. 3. Suicidal behavior in the post-totalitarian society exists in a special social, psychological, and cultural context that creates obstacles for its effective prevention. 4. Research on the level of suicide knowledge revealed a high prevalence of mythical ideas, even in those groups of the population or professional groups that should be directly involved in education and participate in suicide prevention. 5. An assessment of the attitude of the respondents toward suicide revealed an ambivalence of their feelings and attitudes that could have a negative influence on their practical involvement in helping to deal with suicidal clients.

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