Nutritional-status assessment using body-composition monitor device in a cohort of end-stage renal disease on maintenance hemodialysis

Over 50% of end-stage renal disease (ESRD) patients die of cardiovascular disease. ESRD patients treated with maintenance hemodialysis are repeatedly exposed to oxidative stress. The aim of the study was to find the relationship between lifestyle factors, nutritional status, calcium-phosphate metabolism, and selected redox parameters such as glutathione peroxidase (GPx), glutathione reductase (GR), superoxide dismutase (SOD), uric acid (UA), and total antioxidant capacity expressed as ferric reducing antioxidant power (FRAP). The study included 97 ESRD hemodialysis patients and 42 controls with no renal disease. Patients were asked to complete a questionnaire which gathered information on their physical activity, hours of sleep, smoking, and frequency of fruit and vegetable intake; the blood samples were then drawn before the midweek dialysis session. The ESRD patients had lower levels of GR, GPx, and SOD activity, a lower level of FRAP, and a higher UA concentration than the control group. The FRAP value decreased with age (ρ=−0.32, p=0.001); smokers had a significantly lower SOD activity in comparison to nonsmokers (p=0.03). In the ESRD patients, FRAP and UA correlated with both albumin (ρ=0.26, p=0.011; ρ=0.41, p=0.006, respectively) and prealbumin (ρ=0.34, p≤0.001; ρ=0.28, p=0.006, respectively), whereas UA, GR, GPx, and SOD correlated with calcium, UA, GR, and GPx with phosphate level. Based on the findings, there are weak associations between nutritional status and selected redox parameters in hemodialyzed patients. Further studies are needed to establish if diet modifications and adequate nutritional status can positively impact the antioxidant capacity in this group of patients.

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Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis

Journal of Nepal Medical Association ◽

10.31729/jnma.179 ◽

2009 ◽

Vol 48 (173) ◽

Cited By ~ 1

Author(s):

P Sultania ◽

Sanjib Kumar Sharma ◽

SK Sharma

Keyword(s):

Observational Study ◽

Nutritional Status ◽

Renal Disease ◽

End Stage Renal Disease ◽

Maintenance Hemodialysis ◽

Inclusion Criteria ◽

Cross Sectional ◽

Dialysis Unit ◽

Stage Renal Disease ◽

End Stage

INTRODUCTION:Inadequate dialysis accounts for the high mortality in patients with end stage renal disease (ESRD). In Nepal, due to various factors including financial and logistic limitations, hemodialysis is mostly performed twice-a-week. This study was undertaken to look at adequacy of dialysis in patients undergoing maintenance hemodialysis in Nepal where the patients profile, in terms of diet, body muscle mass, nutritional status etc are different from western world.METHODS:In this cross sectional observational study, 40 patients on maintenance hemodialysis in the dialysis unit were evaluated and enrolled if patients were regularly undergoing twice-a-week hemodialysis in preceding 6 months with each session of dialysis prescription consisting of 4 hours (240 minutes). Patients were excluded if they were admitted in the hospital for some acute problems or had received acute hemodialysis in preceding 6 months. Only 14 patients fulfilled the inclusion criteria. Hemodialysis adequacy was measured using well established urea kinetic modeling.RESULTS:The mean age of the patients was 49 +/- 24 years. Mean predialysis urea and post dialysis urea were 163.7 +/- 60.05 mg/dL, and 73.7 mg/dL +/- 30.55 respectively. Mean URR was 65.3%. Mean Kt/v as assessed by Jindals equation was 0.99.CONCLUSIONS:Our study showed that twice-a-week of maintenance hemodialysis did not achieve recommended adequacy of hemodialysis in our patients.Key words: Adequacy of dialysis, end stage renal disease, hemodialysis.

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P1379PLATELET/LYMPHOCYTE RATIO AS A MARKER OF ERYTHROPOIETIN RESPONSIVENESS IN END-STAGE RENAL DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1379 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Sonja Golubović ◽

Tijana Azasevac ◽

Siniša Živković ◽

Bojana Ljubiäiä‡ ◽

Violeta Knezevic ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Laboratory Data ◽

Moderate Intensity ◽

Maintenance Hemodialysis ◽

Weekly Dose ◽

Lymphocyte Ratio ◽

Stage Renal Disease ◽

End Stage ◽

Esa Therapy

Abstract Background and Aims Neutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) are closely associated with increased inflammation in end-stage renal disease, which often contributes to the severity of anemia in these patients. Erythropoiesis stimulating agents (ESA) have become a standard treatment of anemia in hemodialysis patients. Since some patients do not respond well to erythropoietin therapy (EPO) the aim of this study is to investigate if NLR and PLR as markers of increased inflammation, could be associated with resistance to EPO therapy. Method A total of 90 patients (36 females, 54 males; mean age 60,45 ±11,58) undergoing maintenance hemodialysis and who received recombinant human EPO therapy were examined. Patients' clinical characteristics, laboratory data, dialysis adequacy and the applied doses os EPO were examined in a period of 3 months. EPO hyporesponsiveness index (EHRI) was calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level. Results Obtained results show a statistically significant correlation of moderate-intensity between EHRI and NLR ( r = 0.497, p < 0.01) as well as a negative correlation of moderate-intensity between EHRI and hemoglobin levels (Hgb) (r = -0.403, p < 0.01). When it comes to the connection of NLR and PLR with logarithmically converted EHRI values, the results show that there is no statistically significant correlation between NLR and EHRI. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th towards the 75th percentile (p < 0.01). Post hoc analysis indicated that there is also a statistically strong connection for the 25th i 50th percentile (<0 .05) and furthermore for the 50th and 75th percentile (< 0.05). Conclusion PLR was found to be superior to NLR in terms of evaluating ESA therapy resistance. PLR could be used as a predictor of ESA therapy response.

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Interleukin-1 Gene Cluster Polymorphisms Are Associated with Nutritional Status and Inflammation in Patients with End-Stage Renal Disease

Blood Purification ◽

10.1159/000087196 ◽

2005 ◽

Vol 23 (5) ◽

pp. 384-393 ◽

Cited By ~ 19

Author(s):

Yukio Maruyama ◽

Louise Nordfors ◽

Peter Stenvinkel ◽

Olof Heimbürger ◽

Peter Bárány ◽

...

Keyword(s):

Nutritional Status ◽

Renal Disease ◽

Gene Cluster ◽

End Stage Renal Disease ◽

Interleukin 1 ◽

Stage Renal Disease ◽

End Stage

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Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

Journal of Nepal Medical Association ◽

10.31729/jnma.358 ◽

2012 ◽

Vol 52 (187) ◽

Author(s):

R K Agrawal ◽

S Khakurel ◽

R Hada ◽

D Shrestha ◽

A Baral

Keyword(s):

Renal Failure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Tertiary Care ◽

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Care Hospital ◽

Cross Sectional ◽

Stage Renal Disease ◽

End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

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