scholarly journals Diagnosis, Prevention, and Treatment of Protein-Energy Wasting in Peritoneal Dialysis

2018 ◽  
Author(s):  
Francisco Gerardo Yanowsky-Escatell ◽  
Leonardo Pazarín-Villaseñor ◽  
Jorge Andrade-Sierra ◽  
Christian Santana-Arciniega ◽  
Eduardo de Jesús Torres-Vázquez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Prevention And Treatment

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

Life ◽  
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.

scholarly journals The Diagnosis of Protein Energy Wasting in Chronic Peritoneal Dialysis Patients Is Influenced by the Method of Calculating Muscle Mass. A Prospective, Multicenter Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Cristina Techy Roth-Stefanski ◽  
Naiane Rodrigues de Almeida ◽  
Gilson Biagini ◽  
Natália K. Scatone ◽  
Fabiana B. Nerbass ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Muscle Mass ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Multifrequency Bioimpedance ◽  
Study Population ◽  
The Mean ◽  
Main Factor

Objective: To analyze the concordance and agreement between bioimpedance spectroscopy (BIS) and anthropometry for the diagnosis of protein energy wasting (PEW) in chronic peritoneal dialysis patients.Methods: Prospective, multi-center, observational study using multifrequency bioimpedance device (Body Composition Monitor -BCM®- Fresenius Medical Care) and anthropometry for the diagnosis of PEW as recommended by the International Society of Renal Nutrition and Metabolism (ISRNM). Cohen's kappa was the main test used to analyze concordance and a Bland-Altmann curve was built to evaluate the agreement between both methods.Results: We included 137 patients from three PD clinics. The mean age of the study population was 57.7 ± 14.9, 47.8% had diabetes, and 52.2% were male. We calculated the scores for PEW diagnosis at 3 and 6 months after the first collection (T3 and T6) and on average 40% of the study population were diagnosed with PEW. The concordance in the diagnosis of PEW was only moderate between anthropometry and BIS at both T3 and T6. The main factor responsible for our results was a low to moderate correlation for muscle mass in kilograms, with an r-squared (R2) of 0.35. The agreement was poor, with a difference of more than 10 kg of muscle mass on average and with more than a quarter of all cases beyond the limits of agreements.Conclusion: Current diagnosis of PEW may differ depending on the tools used to measure muscle mass in peritoneal dialysis patients.

Protein-Energy Wasting and Mortality Risk Prediction Among Peritoneal Dialysis Patients

2021 ◽  
Author(s):  
Piyawan Kittiskulnam ◽  
Piyatida Chuengsaman ◽  
Talerngsak Kanjanabuch ◽  
Sirarat Katesomboon ◽  
Somkanya Tungsanga ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Risk Prediction ◽  
Mortality Risk ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy

scholarly journals Nutritional Status in Peritoneal Dialysis: Nutritional Guidelines, Adequacy and the Management of Malnutrition

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1715 ◽  
Author(s):  
Thomas Kiebalo ◽  
Jacqueline Holotka ◽  
Ireneusz Habura ◽  
Krzysztof Pawlaczyk
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Positive Impact ◽  
Protein Energy Wasting ◽  
Innovative Strategies ◽  
Nutritional Recommendations ◽  
Protein Energy ◽  
Accessible Information ◽  
Concise Information ◽  
Treatment Adequacy

The positive impact of nutritional status on the health and treatment adequacy of peritoneal dialyzed patients has been well established. Protein intake is an important factor used to stratify malnutrition, with inadequate intake leading to protein-energy wasting during the course of therapy. In this review, we discuss the recommendations made by nephrological societies regarding nutrition in this population of dialysis patients. Special attention is given to the intake of protein, and recommendations on the intake of micronutrients are also discussed. Furthermore, factors that may impair nutritional intake and balance are discussed, with mention of the innovative strategies utilized to combat them. In light of inconsistent recommendations that vary between each respective society, as well as a general lack of concise information, it is our intention to call for further research regarding nutritional recommendations in peritoneal dialysis (PD), as well as to advocate for clear and accessible information for patients.

scholarly journals Evaluation of Protein-Energy Wasting and Inflammation on Patients Undergoing Continuous Ambulatory Peritoneal Dialysis and its Correlations

2015 ◽  
Vol 7 (6) ◽  
Author(s):  
Venkataramanan Krishnamoorthy ◽  
Sham Sunder ◽  
Himansu Sekhar Mahapatra ◽  
Himanshu Verma ◽  
Neera Sharma ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Energy Wasting ◽  
Protein Energy

scholarly journals Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients

2009 ◽  
Vol 25 (4) ◽  
pp. 1266-1271 ◽  
Author(s):  
H. Y. Choi ◽  
J. E. Lee ◽  
S. H. Han ◽  
T. H. Yoo ◽  
B. S. Kim ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Dysfunction ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy

scholarly journals Comparison of Hemodialysis and Peritoneal Dialysis Patients’ Dietary Behaviors

2020 ◽  
Author(s):  
Seonmi Kim ◽  
Byung Chin Kang ◽  
Hyun-Jung Kim ◽  
Min-Sook Kyung ◽  
Hyung Jung Oh ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutrient Intake ◽  
Protein A ◽  
Dietary Behavior ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Nutritional Factors ◽  
Mortality And Morbidity ◽  
Protein Energy ◽  
Group Serum

Abstract Background: Nutritional factors are associated with high mortality and morbidity in dialysis patients, and protein-energy wasting is regarded as an important one. The modality of dialysis may affect patients’ dietary behavior and nutritional status, but no study has compared the dietary behavior, nutrient intake, and nutritional adequacy of hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: From December 2016 to May 2017, a dietary behavior survey and Semi-quantitative Food Frequency Questionnaire (Semi-FFQ) were conducted on 30 HD patients and 30 PD patients in Ewha Womans University Mokdong Hospital, and laboratory parameters were obtained. The results of prevalent HD and PD patients were then compared. Results: The mean age of HD patients was higher than that of PD patients; HD: 58.5±9.1 years, PD: 49.3±9.7 years ( p = 0.001). In the dietary behavior survey, HD patients showed more appropriate dietary behavior patterns overall than PD patients. In the dietary intake analysis with the Semi-FFQ, energy intake was significantly lower in the PD group than in the HD group due to the lower intake of carbohydrates, fat, and protein. A comparison of nutrient intake-to-recommended allowance ratio between the HD and PD groups revealed that the HD group showed higher nutrient intake than the PD group. Serum albumin and potassium levels were significantly higher in HD than in PD patients. Conclusion: According to this study, the dietary behavior and nutritional intake of prevalent PD patients were worse than those of HD patients.

scholarly journals Lower plasma visceral protein concentrations are independently associated with higher mortality in patients on peritoneal dialysis

2015 ◽  
Vol 113 (4) ◽  
pp. 627-633 ◽  
Author(s):  
Rong Huang ◽  
Yun Liu ◽  
Haishan Wu ◽  
Qunying Guo ◽  
Chunyan Yi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Total Cholesterol ◽  
High Sensitivity ◽  
Protein Energy Wasting ◽  
Cox Models ◽  
Nutritional Parameters ◽  
Reactive Protein ◽  
Protein Energy ◽  
Biochemical Indices

Protein–energy wasting (PEW) is strongly associated with high mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, its clinical assessment has not been well defined. The aim of the present study was to investigate the relationship between combined nutritional indicators and mortality in CAPD patients. In the present retrospective cohort study, a total of 885 incident CAPD patients were enrolled. Nutritional status at the initiation of CAPD was assessed by BMI and biochemical indices (serum albumin, prealbumin, transferrin, creatinine and total cholesterol). The primary outcome was all-cause mortality. Principal components factor analysis was used to identify the combined nutritional parameters. Their association with mortality was examined by multivariable-adjusted Cox models. The mean age was 47·4 (sd14·8) years, 59·2 % (n524) were male and 24·6 % (n218) were diabetic. Of the total patients, 130 (14·7 %) had BMI < 18·5 kg/m2, 439 (49·6 %) had albumin < 38 g/l ( < 3·8 g/dl), 303 (34·2 %) had prealbumin < 300 mg/l ( < 30 mg/dl), 404 (45·6 %) had transferrin < 2 g/l ( < 200 mg/dl), 501 (56·6 %) had total cholesterol < 5·2 mmol/l ( < 200 mg/dl) and 466 (52·7 %) had creatinine < 707 μmol/l ( < 8 mg/dl). Overall, three components such as visceral proteins, muscle-mass surrogate and BMI were extracted, which explained 69·95 % of the total variance of the nutritional parameters. After adjusting for demographic variables, co-morbid conditions, Hb, TAG and high-sensitivity C-reactive protein, the factor score of visceral proteins including albumin, prealbumin and transferrin was independently associated with mortality (hazard ratio 0·73, 95 % CI 0·60, 0·89;P= 0·002). Lower visceral protein concentrations may be independently associated with higher mortality in incident CAPD patients. Simultaneous measurements of serum albumin, prealbumin and transferrin could be helpful to monitor PEW.

scholarly journals Nutrition in Older Adults on Peritoneal Dialysis

2015 ◽  
Vol 35 (6) ◽  
pp. 655-658 ◽  
Author(s):  
Lina Johansson
Keyword(s):  
Older Adults ◽  
Peritoneal Dialysis ◽  
Clinical Management ◽  
Well Being ◽  
Life Changes ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Potential Impact ◽  
Physical Changes

Nutrition in older adults on peritoneal dialysis is an important aspect of a patient's clinical management as well as being influenced by their overall well-being, both mental and physical. This is especially pertinent as individuals age, since the potential impact of life changes and physical changes contribute to the development of protein-energy wasting and potentially exacerbating sarcopenia and wasting. This article provides an outline of the nutritional issues to consider in older adults on peritoneal dialysis (PD).

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