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.
Purpose: Patients undergoing hemodialysis (HD) treatment can have a low intake of dietary ber-rich food groups to decrease hyperkalemia risk. This multicenter cross-sectional study aimed to investigate the frequency of intake of dietary ber sources, its determinants, and the relationship with hyperkalemia in HD patients.Methods: HD patients from four dialysis clinics answered a food frequency questionnaire (FFQ) involving the main dietary ber sources with seven frequency possibilities. The answers were converted into scores. Each score point corresponded to one time per week. Demographic, nutritional, and laboratory data were obtained from the medical records. Univariate analysis was used to assess total score associations, and variables with P<0.20 were included in the regression analysis model.Results: A total of 305 HD patients were included (male: 51%; age: 52.2±14.7 years; hyperkalemia: 29%). The median (interquartile) FFQ scores were as follows: fruits, 6 (2-14); vegetables, 6 (3-10); legumes, 3(1-7); whole-grain, 0 (0-1); and seeds, 0 (0-0); total score, 19 (14-28). No difference was found between the dietary ber food groups and total scores with hyperkalemia. Independent predictors of dietary ber total score were older age, higher HD vintage, higher body mass index (BMI), and higher educational level. Conclusion:The usual frequency of dietary ber food groups intake was low, and its independent determinants were age, HD vintage, BMI, and education. The lack of association with hyperkalemia suggests that other dietary sources and clinical factors should be considered when managing hyperkalemia in this population.
Purpose: Patients undergoing hemodialysis (HD) treatment can have a low intake of dietary fiber-rich food groups to decrease hyperkalemia risk. This multicenter cross-sectional study aimed to investigate the frequency of intake of dietary fiber sources, its determinants, and the relationship with hyperkalemia in HD patients. Methods: HD patients from four dialysis clinics answered a food frequency questionnaire (FFQ) involving the main dietary fiber sources with seven frequency possibilities. The answers were converted into scores. Each score point corresponded to one time per week. Demographic, nutritional, and laboratory data were obtained from the medical records. Univariate analysis was used to assess total score associations, and variables with P<0.20 were included in the regression analysis model.Results: A total of 305 HD patients were included (male: 51%; age: 52.2±14.7 years; hyperkalemia: 29%). The median (interquartile) FFQ scores were as follows: fruits, 6 (2–14); vegetables, 6 (3–10); legumes, 3 (1–7); whole-grain, 0 (0–1); and seeds, 0 (0–0); total score, 19 (14–28). No difference was found between the dietary fiber food groups and total scores with hyperkalemia. Independent predictors of dietary fiber total score were older age, higher HD vintage, higher body mass index (BMI), and higher educational level.Conclusion: The usual frequency of dietary fiber food groups intake was low, and its independent determinants were age, HD vintage, BMI, and education. The lack of association with hyperkalemia suggests that other dietary sources and clinical factors should be considered when managing hyperkalemia in this population.
Background and Aims Constipation is a multifactorial gastrointestinal disorder commonly found in hemodialysis (HD) patients. In this multi-centre cross-sectional study, we aimed to evaluate the prevalence and factors associated with constipation, including the frequency of dietary fiber sources intake. Method Prevalent HD patients from four dialysis clinics in Southern Brazil were invited to participate (at least 80% of eligible patients from each clinic). Patients were interviewed by the researchers and answered a questionnaire that comprised ROMA III criteria questions to assess constipation status, use of medications and life habits. A food frequency questionnaire (FFQ) with the main dietary fiber sources (fruits, vegetables, legumes, whole grains cereals and seeds) was applied with seven frequency possibilities (from never to more than twice a day). To estimate the weekly frequency of intake, answers were transformed into a score. Every score point corresponded to one time per week (ex.: score 7 = seven times per week). Demographical and laboratory data were obtained from medical records. Univariate analysis was used to compare participants according to constipation status and variables with P<0.20 were included in the regression analysis model. Results 305 HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19 – 82) months). Ninety-three participants had constipation (30.5%). Median (interquartile) FFQ scores were: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole-grain: 0 (0-1) and seeds: 0 (0-0). In univariate analysis, participants with constipation were significantly older (55.1 ± 14.8 versus 51.0 ± 14.5 years old; P=0.02), had lower literacy (5 (5-11) versus 8 (4-13) years at school; P=0.007), higher prevalence of diabetes (41 versus 23%; P=0.002) and lower total beverage intake (15 (12-20) versus 17 (12-24) ml/kg/day; P=0.04). The logistic regression analysis model also included body mass index; wheelchair need; sedentarism; fruits score and seeds score (all with P<0.20 in the univariate analysis).The independent predictors of constipation were diabetes (OR=1.96 (95%IC 1.07-3.6);P=0.03) and fruits intake score (OR=0.95 (95%IC 0.91-0.99);P=0.04) Conclusion Almost one-third of participants had constipation, and usual intake of fiber food sources was low. The independent determinants of constipation were diabetes and a lower frequency of fruit intake. Nutritional counselling to increase fiber intake sources can potentially decrease the prevalence of constipation of this population.
Background and Aims Patients undergoing hemodialysis (HD) treatment usually have a low intake of food groups rich in dietary fiber to avoid hyperkalemia. However, dietary potassium is not associated with serum potassium or hyperkalemia in recent studies, and higher intake of fiber food groups such as fruits and vegetables is associated with lower mortality and other complications in HD populations. This multicenter cross-sectional study aimed to investigate the frequency of intake of dietary fiber sources, its determinants, and the relationship with hyperkalemia in HD patients. Method Prevalent HD patients from four dialysis clinics in Southern Brazil were invited to participate (at least 80% of eligible patients from each clinic). Patients were interviewed by the researchers and answered a food frequency questionnaire (FFQ) with the main dietary fiber sources (fruits, vegetables, legumes, whole grains cereals and seeds) with seven frequency possibilities (from never to more than twice a day). To estimate the weekly frequency of intake, answers were transformed into a score. Every score point corresponded to one time per week (ex.: score 7 = seven times per week). The sum of the five scores was calculated to determine the total score. Demographical and laboratory data were obtained from medical records. Univariate analysis was used to assess total score associations, and the variables with P<0.20 were included in the regression analysis model. Results 305 HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19 – 82) months; hyperkalemia: 29%). Median (interquartile) FFQ scores were: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole-grain: 0 (0-1) and seeds: 0 (0-0). Total score was 19 (14-28) and correlated with age (r=0.15; P=0.01), HD vintage (r=-0.22; P=<0.001) and body mass index (BMI) (r=0.15; P=0.007). Patients with diabetes had a higher total score (22 (15-31) versus 18 (13-27) P=0.03). Only the vegetables score correlated with serum potassium (r=0.17; P=0.03) and no difference was found between dietary fiber food groups scores and total score with hyperkalemia. The linear regression analysis model also included gender and education (years at school) (all with P<0.20 in the univariate analysis). The independent predictors of dietary fiber total score were age (OR=0.1 (95%IC 0.01-0.20);P=0.04), HD vintage (month) (OR=-0.03 (95%IC -0.06 - -0.01);P=0.02) and years at school (OR=0.27 (95%IC 0.85-0.46);P=0.005). Conclusion The usual frequency of intake of fiber sources was low, and its independent determinants were age, HD vintage and education. The lack of association with hyperkalemia suggests that other dietary sources and clinical factors should be considered to manage hyperkalemia in this population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.