EBPG Guideline on Nutrition

Fouque, Denis; Vennegoor, Marianne; Wee, Piet ter; Wanner, Christoph; Başçı, Alı; Canaud, Bernard; Haage, Patrick; Könner, Klaus; Kooman, Jeroen P.; Martín‐Malo, Alejandro; Pedrini, L.; Pizzarelli, Francesco; Tattersall, James; Tordoir, Jan; Vanholder, Raymond

doi:10.1093/ndt/gfm020

Cited by 487 publications

(514 citation statements)

References 136 publications

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“…Although malnutrition may be a modifiable risk factor for clinical outcomes (including death), limited information is available on how best to assess body composition in persons with CKD. International guidelines recommend the combined use of anthropometry, bioelectrical impedance analysis, and dual x-ray absorptiometry in patients receiving dialysis, but little information is available to guide clinical assessment of nutritional status in CKD patients not yet requiring dialysis (2)(3)(4). Although simple, inexpensive, and safe, anthropometric measures, such as body mass index (BMI), arm circumference, mid-arm muscle circumference, and skinfolds, have several limitations and therefore, are used in combination with other tools, such as bioelectrical impedance analysis (4).…”

Section: Introductionmentioning

confidence: 99%

Urine Creatinine Excretion and Clinical Outcomes in CKD

Micco

Quinn

Ronksley

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Twenty-four-hour urine creatinine excretion is a reliable approximation of muscle mass. Whether changes in urine creatinine predict clinical outcomes in persons with CKD is unknown. This work studied the relationship between urine creatinine and patient and renal survival in people with CKD not requiring renal replacement therapy.Design, setting, participants, & measurements This longitudinal cohort study included incident stages 3-5 CKD patients referred to the renal clinic at the University Federico II in Naples between January of 1995 and December of 2005. Clinical data and urine creatinine were updated at each visit. Main outcomes were all-cause mortality and kidney failure requiring dialysis.Results This study enrolled 525 individuals and followed them for a median of 6 years (range of 4 months to 15 years). Urine creatinine excretion declined by 16 mg/d per year (95% confidence interval, 14 to 19) in participants with CKD stages 3a, 3b, and 4, and it remained stable in participants with stage 5 CKD. Per each 20 mg/d decline in urine creatinine, mortality increased by 3% (adjusted hazard ratio, 1.03; 95% confidence interval, 1.01 to 1.05), and the risk of initiating dialysis increased by 2% (adjusted hazard ratio, 1.02; 95% confidence interval, 1.01 to 1.03). These associations were independent of body mass index and GFR.Conclusions In persons with CKD stages 3 and 4, urine creatinine declines at a rate of 16 mg/d per year. Lower urine creatinine excretion predicts greater risk of kidney failure and patient mortality.

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Section: Introductionmentioning

confidence: 99%

Urine Creatinine Excretion and Clinical Outcomes in CKD

Micco

Quinn

Ronksley

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…Quanto maior o ganho de peso interdialítico (GPI), maior o risco de complicações. Hoje, o GPI alvo para minimizar as consequências clínicas da hipervolemia recorrente é de até 3% do peso seco 4 .…”

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Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

Lacerda

Viana

Dores

et al. 2015

Rev. odontol. UNESP

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ResumoIntroduçãoA doença renal crônica leva a alterações salivares que interferem na saúde bucal. A imunossupressão no pós-transplante pode facilitar que situações restritas à boca se tornem sistêmicas.ObjetivoCaracterizar a saúde bucal de pacientes renais crônicos aptos a transplante, avaliando fluxo e pH salivar, capacidade tamponante salivar (CTS), lesões estomatológicas, sangramento gengival, cálculo e índice de dentes cariados, perdidos e obturados (CPOD).Material e métodoEstudo transversal, observacional e analítico. Foi coletada saliva não estimulada de 83 voluntários, com hipofluxo salivar caracterizado como < 0,3 mL/min. O pH salivar foi mensurado por fita e considerado alcalino quando > 7. A CTS foi avaliada pela Técnica de Ericsson. Um único examinador calibrado procedeu às avaliações clínicas. Foram utilizados Teste Exato de Fisher, ANOVA e Regressão Linear, com nível de significância de 0,05 e Intervalo de Confiança de 95%.ResultadoHipofluxo salivar esteve presente em 61% da amostra e foi influenciado pelo ganho hídrico interdialítico (p=0,01). A presença de pH salivar alcalino foi influenciada pela ureia sérica (p<0,01) e pela hiperfosfatemia (p=0,01). A CTS foi ótima em 92% e sofreu influência do pH salivar (p=0,02). Três indivíduos apresentaram lesões estomatológicas infecciosas. Sangramento gengival esteve presente em 55%, cálculo em 94% e cárie em 88%. O índice CPOD da amostra foi 17,9 ± 7,48.ConclusãoA saúde bucal dos voluntários foi considerada precária e esse agravo pode se tornar mais maléfico se esses indivíduos forem transplantados. Salienta-se a importância da inserção do Dentista na equipe que assiste o renal crônico.

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“…The European guidelines recommend that the percentage of interdialytic weight gain (IDWG) should be between 4 and 4.5% of body weight at most [9], while the K/DOQI, 2000 has set a 5% limit [14], because complications such as cardiac dysfunction and pulmonary congestion arise from excessive IDWG, particularly in patients with reduced diuresis. Adherence to adequate fluid intake is commonly measured by IDWG [21].…”

Section: Discussionmentioning

confidence: 99%

“…Simultaneously, there is an increase in energy expenditure, which can last up to two hours after the dialysis session [6,7]. Other factors also contribute to the genesis of protein-energy malnutrition, such as: loss of amino acids during dialysis (4-8 grams per HD session on average, reaching up to 20 grams with highflux dialyzers), metabolic acidosis and low food intake [8,9].…”

Section: Research Articlementioning

confidence: 99%