950 results match your criteria protein-energy wasting

Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients.

Nutrients 2021 May 30;13(6). Epub 2021 May 30.

Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.

Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34. Read More

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Maintenance of Skeletal Muscle to Counteract Sarcopenia in Patients with Advanced Chronic Kidney Disease and Especially Those Undergoing Hemodialysis.

Katsuhito Mori

Nutrients 2021 May 2;13(5). Epub 2021 May 2.

Department of Nephrology, Osaka City University Graduate School of Medicine 1-4-3, Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan.

Life extension in modern society has introduced new concepts regarding such disorders as frailty and sarcopenia, which has been recognized in various studies. At the same time, cutting-edge technology methods, e.g. Read More

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Chronic Kidney Disease as a Systemic Inflammatory Syndrome: Update on Mechanisms Involved and Potential Treatment.

Life (Basel) 2021 May 5;11(5). Epub 2021 May 5.

Department of Systems Medicine, Nephrology and Dialysis Unit, University of Rome Tor Vergata, via Montpellier 1, 00133 Rome, Italy.

Chronic kidney disease (CKD) is characterized by manifestations and symptoms involving systemic organs and apparatus, associated with elevated cardiovascular morbidity and mortality, bone disease, and other tissue involvement. Arterial hypertension (AH), diabetes mellitus (DM), and dyslipidemia, with glomerular or congenital diseases, are the traditional risk factors recognized as the main causes of progressive kidney dysfunction evolving into uremia. Acute kidney injury (AKI) has recently been considered an additional risk factor for the worsening of CKD or the development of CKD de novo. Read More

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Protein energy wasting and long-term outcomes in nondialysis dependent chronic kidney disease.

J Ren Care 2021 May 30. Epub 2021 May 30.

Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Background: Nutritional status and protein energy wasting (PEW) is prevalent in patients with nondialysis-dependent chronic kidney disease (CKD). The relationship between PEW and long-term development of clinically important outcomes remains to be examined.

Objectives: To investigate the relationships between PEW, as measured by Subjective Global Assessment (SGA 1-7), and progression to important clinical outcomes: mortality and/or kidney failure. Read More

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Methods and Nutritional Interventions to Improve the Nutritional Status of Dialysis Patients in JAPAN-A Narrative Review.

Nutrients 2021 Apr 21;13(5). Epub 2021 Apr 21.

Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Shizuoka 431-3192, Japan.

Patients receiving dialysis therapy often have frailty, protein energy wasting, and sarcopenia. However, medical staff in Japan, except for registered dietitians, do not receive training in nutritional management at school or on the job. Moreover, registered dietitians work separately from patients and medical staff even inside a hospital, and there are many medical institutions that do not have registered dietitians. Read More

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Optimal Protein Intake in Pre-Dialysis Chronic Kidney Disease Patients with Sarcopenia: An Overview.

Yoshitaka Isaka

Nutrients 2021 Apr 6;13(4). Epub 2021 Apr 6.

Department of Nephrology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.

Multi-factors, such as anorexia, activation of renin-angiotensin system, inflammation, and metabolic acidosis, contribute to malnutrition in chronic kidney disease (CKD) patients. Most of these factors, contributing to the progression of malnutrition, worsen as CKD progresses. Protein restriction, used as a treatment for CKD, can reduce the risk of CKD progression, but may worsen the sarcopenia, a syndrome characterized by a progressive and systemic loss of muscle mass and strength. Read More

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A Comparison of Dietary Intake Between Individuals Undergoing Maintenance Hemodialysis in the United Kingdom and China.

J Ren Nutr 2021 Apr 19. Epub 2021 Apr 19.

Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; School of Sport, Exercise & Health Sciences, Loughborough University, United Kingdom.

Objective: Protein-energy wasting is highly prevalent in people with end-stage kidney disease receiving regular hemodialysis. Currently, it is unclear what the optimal nutritional recommendations are, which is further complicated by differences in dietary patterns between countries. The aim of the study was to understand and compare dietary intake between individuals receiving hemodialysis in Leicester, UK and Nantong, China. Read More

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Natriuretic Peptides as Predictors of Protein-Energy Wasting in Hemodialysis Population.

J Ren Nutr 2021 Apr 19. Epub 2021 Apr 19.

Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Benite, France; University of Lyon, CarMeN lab, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France. Electronic address:

Objective: Imbalance between anabolism and catabolism is linked to cachexia and protein-energy wasting (PEW), especially in frail populations such as patients with chronic kidney disease. PEW is responsible of poor outcomes with increased morbidity and mortality. Several causes are involved in PEW such as insulin resistance, acidosis, or hyperparathyroidism. Read More

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Tales of two study designs in patients with chronic kidney failure: The case of the protein-energy wasting - inflammation syndromic complex.

J Intern Med 2021 Apr 21. Epub 2021 Apr 21.

Nephrology, Dialysis and Renal Transplantation Unit, Grande Ospedaliera Metropolitano, Reggio Calabria, Italy.

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Fatigue in CKD: Epidemiology, Pathophysiology, and Treatment.

Clin J Am Soc Nephrol 2021 Apr 15. Epub 2021 Apr 15.

Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas

Fatigue is a commonly reported and debilitating symptom among patients with CKD, yet little is known about its epidemiology, pathogenesis, and treatment. Various measurement tools have been used in published studies to identify and quantify fatigue. These include several single-item measures embedded in longer questionnaires for assessing depression, quality of life, or symptom burden in patients with kidney disease. Read More

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Creatine homeostasis and protein energy wasting in hemodialysis patients.

J Transl Med 2021 03 20;19(1):115. Epub 2021 Mar 20.

Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands.

Muscle wasting, low protein intake, hypoalbuminemia, low body mass, and chronic fatigue are prevalent in hemodialysis patients. Impaired creatine status may be an often overlooked, potential contributor to these symptoms. However, little is known about creatine homeostasis in hemodialysis patients. Read More

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Dietary protein intake, kidney function, and survival in a nationally representative cohort.

Am J Clin Nutr 2021 Mar 19. Epub 2021 Mar 19.

Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.

Background: High-protein diets (e.g., Paleo, Atkins, South Beach, ketogenic) have gained popularity as a means to promote weight loss and avoid excess carbohydrate consumption. Read More

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Chronic Kidney Disease and Nutrition Support.

Winnie Chan

Nutr Clin Pract 2021 Apr 18;36(2):312-330. Epub 2021 Mar 18.

School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham, Edgbaston, Birmingham, United Kingdom.

Individuals with chronic kidney disease (CKD), particularly those undergoing maintenance dialysis, are prone to protein-energy wasting (PEW), the latter of which can be ameliorated with different methods of nutrition support. Dietary counseling guided by dietitians is the key for preventing and managing PEW in CKD. If dietary counseling per se fails to meet the recommended energy and protein requirements, the addition of oral nutrition supplements (ONSs) would be necessary. Read More

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Resting metabolic rate and its adjustments as predictors of risk protein-energy wasting in hemodialysis patients.

Biosci Rep 2021 Apr;41(4)

Renal Division, Department of Medicine, Guizhou Provincial People's Hospital.

Background: The purpose of the present study was to explore the association between resting metabolic rate (RMR) and protein-energy wasting (PEW) risk in Chinese hemodialysis patients by age and gender subgroup.

Methods: RMR and body composition (body cell mass (BCM) and fat mass) of 774 patients undergoing hemodialysis were estimated by bio-electrical impedance analysis (BIA). Anthropometric data were collected by a standard measurement protocol, and the upper arm muscle circumference (AMC) was calculated. Read More

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

J Ren Nutr 2021 Feb 25. Epub 2021 Feb 25.

Department of Internal Medicine-Nephrology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Special Task Force for Activating Research in Renal Nutrition (Renal Nutrition Research Group), Office of Research Affairs, Chulalongkorn University, Bangkok, Thailand. Electronic address:

Objectives: Protein-energy wasting (PEW) is defined as the loss of body protein and energy reserves associated with kidney disease. However, the extent to which PEW contributes to increased mortality among peritoneal dialysis (PD) patients remains unclear.

Methods: This is a retrospective cohort study from 2012 to 2020. Read More

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February 2021

Low Serum Potassium Levels and Clinical Outcomes in Peritoneal Dialysis-International Results from PDOPPS.

Kidney Int Rep 2021 Feb 22;6(2):313-324. Epub 2020 Nov 22.

St. Michael's Hospital, Toronto, Ontario, Canada.

Introduction: Hypokalemia, including normal range values <4 mEq/l, has been associated with increased peritonitis and mortality in patients with peritoneal dialysis. This study sought to describe international variation in hypokalemia, potential modifiable hypokalemia risk factors, and the covariate-adjusted relationship of hypokalemia with peritonitis and mortality.

Methods: Baseline serum potassium was determined in 7421 patients from 7 countries in the Peritoneal Dialysis Outcomes and Practice Patterns Study (2014-2017). Read More

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February 2021

Impact of Circulating N-Acylethanolamine Levels with Clinical and Laboratory End Points in Hemodialysis Patients.

Am J Nephrol 2021 18;52(1):59-68. Epub 2021 Feb 18.

Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Irvine, California, USA,

Background: Patients with ESRD on maintenance hemodialysis (MHD) are particularly susceptible to dysregulation of energy metabolism, which may manifest as protein energy wasting and cachexia. In recent years, the endocannabinoid system has been shown to play an important role in energy metabolism with potential relevance in ESRD. N-acylethanolamines are a class of fatty acid amides which include the major endocannabinoid ligand, anandamide, and the endogenous peroxisome proliferator-activated receptor-α agonists, oleoylethanolamide (OEA) and palmitoylethanolamide (PEA). Read More

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February 2021

Ketoanalogue supplements reduce mortality in patients with pre-dialysis advanced diabetic kidney disease: A nationwide population-based study.

Clin Nutr 2021 Feb 6. Epub 2021 Feb 6.

Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. Electronic address:

Background & Aims: Metabolism dysregulation and protein energy wasting occur in patients with chronic kidney disease (CKD) and are associated with poor survival, especially in patients prior to starting dialysis. Accumulating evidence indicates that dietary supplementation with ketoanalogues (KAs, a mixture of branched-chain amino acids) exerts a variety of beneficial effects for patients with CKD. However, the role of KAs in diabetic kidney disease (DKD), one of the major causes of CKD, is still controversial. Read More

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February 2021

Fibroblast growth factor 21 and protein energy wasting in hemodialysis patients.

Clin Nutr 2021 Feb 3. Epub 2021 Feb 3.

Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address:

Introduction: Protein energy wasting (PEW) is the most important risk factor for morbidity and mortality in hemodialysis patients. Inadequate dietary protein intake is a frequent cause of PEW. Recent studies have identified fibroblast growth factor 21 (FGF21) as an endocrine protein sensor. Read More

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February 2021

Association between the uremic toxins indoxyl-sulfate and p-cresyl-sulfate with sarcopenia and malnutrition in elderly patients with advanced chronic kidney disease.

Exp Gerontol 2021 05 30;147:111266. Epub 2021 Jan 30.

Unit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy. Electronic address:

Background: in patients with chronic kidney disease (CKD) indoxyl sulfate (IS) and p-cresyl sulfate (PCs) may induce sarcopenia either directly or via systemic inflammation. We evaluated whether IS and PCs were associated with: sarcopenia, systemic inflammation and nutritional status.

Methods: we examined cross sectionally 93 patients with advanced CKD. Read More

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Slipping Through the Pores: Hypoalbuminemia and Albumin Loss During Hemodialysis.

Int J Nephrol Renovasc Dis 2021 20;14:11-21. Epub 2021 Jan 20.

Fresenius Medical Care Renal Therapies Group, Waltham, MA, USA.

Hypoalbuminemia results when compensatory mechanisms are unable to keep pace with derangements in catabolism/loss and/or decreased synthesis of albumin. Across many disease states, including chronic kidney disease (CKD), hypoalbuminemia is a well-established, independent risk factor for adverse outcomes, including mortality. In the setting of CKD, reduced serum albumin concentrations are often a manifestation of protein-energy wasting, a state of metabolic and nutritional alterations resulting in reduced protein and energy stores. Read More

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January 2021

Association of the erythropoiesis-stimulating agent resistance index and the geriatric nutritional risk index with cardiovascular mortality in maintenance hemodialysis patients.

PLoS One 2021 15;16(1):e0245625. Epub 2021 Jan 15.

Division of Medical Statistics, Fujita Health University School of Medicine, Aichi, Japan.

Objective: Hyporesponsiveness to erythropoiesis-stimulating agent (ESA) may be associated with protein-energy wasting. We investigated the relationship of the ESA resistance index (ERI) and the geriatric nutritional risk index (GNRI) for cardiovascular mortality in hemodialysis (HD) patients.

Methods: A total of 180 maintenance HD patients were enrolled. Read More

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January 2021

Circulating fatty acid profiles are associated with protein energy wasting in maintenance hemodialysis patients: a cross-sectional study.

Sci Rep 2021 Jan 14;11(1):1416. Epub 2021 Jan 14.

School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia.

The metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55. Read More

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January 2021

Comparison of nutritional and hydration status in patients undergoing twice and thrice-weekly hemodialysis: a silent drama in developing countries.

Int Urol Nephrol 2021 Mar 4;53(3):571-581. Epub 2021 Jan 4.

Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Sección XVI, Delegación Tlalpan, Ciudad de México, 14000, México.

Purpose: In low and middle- income countries, due to lack of financial resources, the number of patients receiving one or two hemodialysis (HD) sessions a week has increased, leading to a large number of complications. Protein-energy wasting (PEW) and overhydration (OH) are common complications; nevertheless, the evidence regarding the nutritional status of patients receiving 2 and 3 weekly dialysis sessions is scarce. Thus, our objective was to compare the nutritional and hydration status of patients with two and three HD sessions. Read More

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Evolution of body composition and wasting indicators by time of day of haemodialysis.

Nephrol Dial Transplant 2021 01;36(2):346-354

European Renal Nutrition Working Group, European Renal Association-European Dialysis Transplant Association, London, United Kingdom.

Background: It has been a long-standing clinical concern that haemodialysis (HD) patients on afternoon shifts (ASs) are more prone to protein-energy wasting (PEW) than those on morning shifts (MSs), as their dialysis scheme and post-dialysis symptoms may interfere with meal intake. We evaluated the effect of time of day of HD on the evolution of body composition changes and PEW surrogates.

Methods: We conducted a retrospective study among 9. Read More

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January 2021

Protein intake and renal function in older patients.

Curr Opin Clin Nutr Metab Care 2021 Jan;24(1):10-17

Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California.

Purpose Of Review: Chronic kidney disease (CKD) is highly prevalent in elderly patients. There is growing recognition of the importance of attention to dietary protein intake (DPI) in this population given their predisposition to age-related changes in kidney function and coexisting comorbidities (i.e. Read More

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January 2021

Dynapenia and sarcopenia in chronic haemodialysis patients: do muscle weakness and atrophy similarly influence poor outcome?

Nephrol Dial Transplant 2020 Dec 11. Epub 2020 Dec 11.

Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France.

Background And Aims: Sarcopenia, defined as a decline in both muscle mass and function, has been recognized as a major determinant of poor outcome in hemodialysis patients. It is generally assumed that sarcopenia is driven by muscle atrophy related to protein energy wasting. However, dynapenia, defined as weakness without atrophy, has been characterized by a different disease phenotype from sarcopenia. Read More

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December 2020

Association of Ultrasound-Derived Metrics of the Quadriceps Muscle with Protein Energy Wasting in Hemodialysis Patients: A Multicenter Cross-Sectional Study.

Nutrients 2020 Nov 23;12(11). Epub 2020 Nov 23.

School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, No 1, Jalan Taylor's, Subang Jaya 47500, Selangor, Malaysia.

This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of (RF) and (VI) muscles and cross-sectional area (CSA) of the RF muscle (RF) were measured using US and compared with other physical measures. Read More

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November 2020

Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease.

Pediatr Nephrol 2021 Jun 18;36(6):1561-1569. Epub 2020 Nov 18.

Faculty of Medicine, Pediatric Department, Mansoura University, Elgomhoria Street, Mansoura, Egypt.

Background: Protein energy wasting (PEW) is a common cause of morbidity and mortality in patients with stage 5 chronic kidney disease (CKD 5). Intradialytic parenteral nutrition (IDPN) has been used as a therapy for preventing and treating PEW in children with CKD 5 when other conventional modalities fail. However, not enough data is available to define its effectiveness in treating malnutrition in children. Read More

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