Food Intake Assessment of Elderly Patients on Hemodialysis

Background/Aims: It is very important to assess the nutritional intake in patients on dialysis given the high prevalence of poor nutritional status of those in this population. The aim of this study was to assess nutrient intakes in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: A clinical cross-sectional study was conducted over 7 days on 14 dialysis patients (98 days) who were trained to keep a weighed food record and a 7-day food diary. Nutrient intake adequacy was compared with specific guidelines for Italians and dialysis patients. Results: The mean daily protein intake (0.92 ± 0.36 g/kg) and energy intake (EI; 25.3 ± 7.4 kcal/kg) were inadequate according to the European best practice guidelines (EBPG). The ratio of EI to resting energy expenditure was 1.22. Inadequate intakes, compared to the EBPG, were found for calcium (525 ± 162 mg/day) and iron (8.7 ± 2.1 mg/day). Dietary fiber (14.7 ± 8.7 g/day), niacin (14.4 ± 5.2 mg/day), thiamine (0.8 ± 0.3 mg/day) and riboflavin (1.1 ± 0.4 mg/day) were also inadequate according to the Italian recommended dietary allowances (LARN). HD patients did not display different nutrient intakes between the dialysis days and the interdialytic period. Overall, the percentage of days during which nutrient recommendations were not satisfied ranged from 16 to 100% depending on the nutrient. Conclusion: Macronutrient and micronutrient intakes in HD and PD patients are largely inadequate compared to the EBPG. The weighed dietary record appears to be a useful and accurate tool for individual assessment of food intake in motivated patients. No nutrient intake differences were found between dialytic and interdialytic days in patients on HD.

show abstract

“…While some studies have found lower food intakes on dialysis days [4,48], our data do not confirm these findings.…”

Section: Discussioncontrasting

confidence: 99%

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Bovio¹,

Esposito

Montagna

et al. 2016

Nephron

View full text Add to dashboard Cite

show abstract

“…A cut‐off of >1.27 was used to define adequate reporting (Martins et al . ). Foodworks software (version 7.0.3016, Xyris software, Highgate Hill, Brisbane, Australia) was used for nutrient analysis.…”

Section: Methodsmentioning

confidence: 97%

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Roach

Lambert

Holt

et al. 2017

Journal of Renal Care

View full text Add to dashboard Cite

SUMMARY Background People on haemodialysis (HD) are at risk of consuming a poor quality diet. This includes inadequate intake of omega‐3 long chain polyunsaturated fatty acids (n‐3 LCPUFA). Objective This study aims to investigate diet quality, with a particular focus on n‐3 LCPUFA intake, in a population of incentre HD patients. Design Dietary intake was measured using three 24 hour recalls; the Polyunsaturated food frequency questionnaire (PUFA FFQ) and the Total Diet Score (TDS). Dietary intake was also compared to evidence based practice guidelines (EBPG). Nutritional status was assessed using the Patient Generated Subjective Global Assessment (PG SGA). Subjects A total of 32 dialysis patients were recruited, from two regional HD centres in New South Wales, Australia. Main Outcome Measure Diet quality was the main outcome measure. Results Diet quality of study participants was poor, with the majority not meeting the EBPG for energy, protein and potassium. All participants exceeded the recommended amount of saturated fat. The mean TDS of the dialysis cohort was 10.2, which was significantly higher than the TDS of 9.3 of a healthy disease free cohort (p < 0.05). Positive correlations were found between TDS and LC omega‐3 intake (r = 0.392) and TDS and total omega‐6 intake (r = 0.363). Only 22% of participants met the suggested dietary target for n‐3 LCPUFA intake. Conclusion Dialysis patients in this study had suboptimal diet quality. Improvements are required for better adherence to the EBPG. Increased consumption of n‐3 LCPUFA fatty acids may also be of benefit.

show abstract

“…A recent cross-sectional study [30] that evaluated 3-day diet records in hemodialysis patients ( n = 54) and non-CKD elderly adults ( n = 47) found that calcium intakes were low (∼500 mg/day) compared with the DRI, but not different between the patients and the controls when all subjects were included. But, when only “adequate reporters” (a small subset of only n = 11 patients and n = 17 controls) were included, the average intake rose to ∼800 mg/day, but was also not different between groups.…”

Section: Calcium Intake In Adult Ckd Patientsmentioning

confidence: 99%

Calcium Balance in Chronic Kidney Disease

Gallant

Spiegel²

2017

Curr Osteoporos Rep

View full text Add to dashboard Cite

Purpose of ReviewThe kidneys play a critical role in the balance between the internal milieu and external environment. Kidney failure is known to disrupt a number of homeostatic mechanisms that control serum calcium and normal bone metabolism. However, our understanding of calcium balance throughout the stages of chronic kidney disease is limited and the concept of balance itself, especially with a cation as complex as calcium, is often misunderstood. Both negative and positive calcium balance have important implications in patients with chronic kidney disease, where negative balance may increase risk of osteoporosis and fracture and positive balance may increase risk of vascular calcification and cardiovascular events. Here, we examine the state of current knowledge about calcium balance in adults throughout the stages of chronic kidney disease and discuss recommendations for clinical strategies to maintain balance as well as future research needs in this area.Recent FindingsRecent calcium balance studies in adult patients with chronic kidney disease show that neutral calcium balance is achieved with calcium intake near the recommended daily allowance. Increases in calcium through diet or supplements cause high positive calcium balance, which may put patients at risk for vascular calcification. However, heterogeneity in calcium balance exists among these patients.SummaryGiven the available calcium balance data in this population, it appears clinically prudent to aim for recommended calcium intakes around 1000 mg/day to achieve neutral calcium balance and avoid adverse effects of either negative or positive calcium balance. Assessment of patients’ dietary calcium intake could further equip clinicians to make individualized recommendations for meeting recommended intakes.

show abstract

Food Intake Assessment of Elderly Patients on Hemodialysis

Cited by 46 publications

References 21 publications

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Inadequate Macronutrient and Micronutrient Intakes in Hemodialysis and Peritoneal Dialysis Patients: Data from a Seven-Day Weighed Dietary Record

Diet quality in patients with end‐stage kidney disease undergoing dialysis

Calcium Balance in Chronic Kidney Disease

Contact Info

Product

Resources

About