Is energy intake underreported in hemodialysis patients?

Vaz, Inaiana Marques Filizola; Freitas, Ana Tereza Vaz de Souza; Peixoto, Maria do Rosário Gondim; Ferraz, Sanzia Francisca; Campos, Marta Izabel Valente Augusto Morais

doi:10.5935/0101-2800.20150056

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…In addition, the prevalence of inadequate energy intake was high, about two third of HD patients in the current study, which was in the line with previous studies [ 21 , 22 ]. On the other hand, the metabolic syndrome was common in HD patients in present study (55.6% HMetS), which were lower than that in Brazil (74.5%) using diagnostic criteria from Harmonizing Metabolic Syndrome [ 41 ], and in the United States (69.3%) using NCEP-ATP III [ 44 ].…”

Section: Discussionsupporting

confidence: 93%

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The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study

et al. 2018

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Dietary energy intake strongly linked to dialysis outcomes. We aimed to explore the optimal cut-off point of energy intake (EI) for identification of metabolic syndrome (MetS) in hemodialysis patients. The cross-sectional data of 243 hemodialysis patients from multi-dialysis centers in Taiwan was used. The dietary intake was assessed by using the three-day dietary questionnaire, and a 24-hour dietary recall, clinical and biochemical data were also evaluated. The MetS was diagnosed by the Harmonized Metabolic Syndrome criteria. The receiver operating characteristic (ROC) curve was to depict the optimal cut-off value of EI for the diagnosis of MetS. The logistic regression was also used to explore the association between inadequate EI and MetS. The optimal cut-off points of EI for identifying the MetS were 26.7 kcal/kg/day for patients aged less than 60 years, or with non-diabetes, and 26.2 kcal/kg/day for patients aged 60 years and above, or with diabetes, respectively. The likelihood of the MetS increased with lower percentiles of energy intake in hemodialysis patients. In the multivariate analysis, the inadequate dietary energy intake strongly determined 3.24 folds of the MetS. The assessment of dietary EI can help healthcare providers detecting patients who are at risk of metabolic syndrome.

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Section: Discussionsupporting

confidence: 93%

“…The inadequate energy intake (IEI) was high prevalence, accounted for about two third of hemodialysis patients [ 21 , 22 ]. The randomized controlled trial on patients with metabolic syndrome concluded that dietary approaches reduced most of the metabolic risk factors [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study

et al. 2018

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“…While acknowledging the limitations of food diaries, many strategies were used to ensure the best quality of 3-day weighed food diaries was obtained, for example, obtaining nutritional information from manufacturers’ websites and supermarkets, visiting cafes and personal email communications for recipes details, weighing food samples if weight was not provided by participants. Notwithstanding, the diaries were still self-reported, and we cannot exclude the presence of social desirability bias and underreporting [ 59 , 60 ]. Second, the food composition databases we used may not have always been accurate due to the ever-changing food market and the complexity of methods of cooking utilized by patients.…”

Section: Discussionmentioning

confidence: 99%

Dietary Sodium and Other Nutrient Intakes among Patients Undergoing Hemodialysis in New Zealand

2018

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This study describes baseline intakes of sodium and other nutrients in a multi-ethnic sample of hemodialysis patients in New Zealand participating in the SoLID Trial between May/2013 to May/2016. Baseline 3-day weighed food record collections were analyzed using Foodworks 8 Professional food composition database, supplemented by other sources of nutrient information. Intakes of dietary sodium and other nutrients were compared with relevant guidelines and clinical recommendations. Eighty-five participants completed a 3-day weighed food record. The mean (SD) sodium intake was 2502 (957) mg/day at and more than half of the participants exceeded recommended intake levels. Sodium intake was positively associated with energy intake. Only 5% of participants met the recommended calorie density; nine percent of participants ate the recommended minimum of 1.2 g/kg of protein per day; 68% of participants were consuming inadequate fiber at baseline. A high proportion of dialysis patients in SoLID Trial did not meet current renal-specific dietary recommendations. The data show excess sodium intake. It is also evident that there was poor adherence to dietary guidelines for a range of other nutrients. A total diet approach is needed to lower sodium intake and improve total diet quality among hemodialysis patients in New Zealand.

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“…Identification of PEW thus far has relied on clinical judgment processes based on an extensive patient assessment. However, the application of the ISRNM diagnostic criteria to diverse hemodialysis (HD) populations is challenging [ 3 ], due to reliance on the indirect measurement of muscle mass using skinfold measurements and norms developed for Caucasian populations [ 8 , 9 ], as well as high prevalence of underreporting of dietary energy and protein intakes [ 10 , 11 ]. It is also noted that ‘serum chemistry’ biomarkers proposed within ISRNM diagnosis criteria are not sufficient or specific enough [ 12 , 13 , 14 , 15 , 16 ] to reflect and detect the PEW syndrome.…”

Section: Introductionmentioning

confidence: 99%

Exploring Metabolic Signature of Protein Energy Wasting in Hemodialysis Patients

et al. 2020

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End-stage renal disease patients undergoing maintenance hemodialysis (HD) are vulnerable to the protein energy wasting (PEW) syndrome. Identification and diagnosis of PEW relies on clinical processes of judgment dependent on fulfilling multiple criteria drawn from serum biochemistry, weight status, predictive muscle mass, dietary energy and protein intakes. Therefore, we sought to explore the biomarkers’ signature with plasma metabolites of PEW by using 1H-nuclear magnetic resonance for an untargeted metabolomics approach in the HD population, to understand metabolic alteration of PEW. In this case-controlled study, a total of 53 patients undergoing chronic HD were identified having PEW based on established diagnostic criteria and were age- and sex-matched with non-PEW (n = 53) HD patients. Fasting predialysis plasma samples were analyzed. Partial least square discriminant analysis demonstrated a significant separation between groups for specific metabolic pattern alterations. Further quantitative analysis showed that the level of 3-hydroxybutyrate, acetate, arabinose, maltose, ribose, sucrose and tartrate were significantly increased whilst creatinine was significantly decreased (all p < 0.05) in PEW subjects. Pathway analysis indicated that PEW-related metabolites reflected perturbations in fatty acid mechanism and induction of glyoxylate and dicarboxylate pathway attributed to gluconeogenesis. These results provide preliminary data in understanding metabolic alteration of PEW and corresponding abnormal metabolites that could potentially serve as biomarkers of PEW.

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Is energy intake underreported in hemodialysis patients?

Abstract: The population showed a high prevalence of underreporting of energy intake. Being a female, presenting overweight, lower number of meals/day and lower length time on hemodialysis were factors associated with underreporting.

Cited by 5 publications

References 18 publications

The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study

The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study

Dietary Sodium and Other Nutrient Intakes among Patients Undergoing Hemodialysis in New Zealand

Exploring Metabolic Signature of Protein Energy Wasting in Hemodialysis Patients

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