Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients

Jagadeswaran, D; Indhumathi, Elayaperumal; Hemamalini, A. J.; Sivakumar, V; Soundararajan, P.; Jayakumar, M

doi:10.1016/j.clnu.2018.01.001

Cited by 55 publications

(62 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, this is a cross-sectional analysis and therefore does not allow conclusions about possible causal relationships. Second, serum albumin and CRP measurements were not included in the analyses because of infrequent measurement, thereby limiting the interpretation of the association between low hemoglobin and pruritus because hemoglobin, albumin, and CRP are all associated with inflammation (42,47,48). Third, the modest sample size of patients with stage 5 CKD may have resulted in a prevalence ratio that was underpowered, affecting the interpretation of this result.…”

Section: Discussionmentioning

confidence: 99%

Pruritus and Patient Reported Outcomes in Non-Dialysis CKD

Sukul¹,

Speyer

et al. 2019

CJASN

View full text Add to dashboard Cite

Background and objectivesAmong patients on hemodialysis, pruritus has been associated with poorer mental and physical quality of life, sleep quality, depression, and mortality. We evaluated patients with nondialysis CKD to describe the prevalence of pruritus, identify associated factors, and investigate associations with patient-reported outcomes.Design, setting, participants, & measurementsUsing cross-sectional data from patient questionnaires in the CKD Outcomes and Practice Patterns Study (CKDopps), we asked patients with CKD stages 3–5 (nondialysis) from the United States, Brazil, and France to identify how much they were bothered by pruritus. Response options ranged from “not at all” to “extremely.” Log-Poisson regression, yielding prevalence ratios, was used to evaluate associations of moderate-to-extreme pruritus with patient characteristics, CKD stage, self-reported depression symptoms, and restless sleep. Mixed linear regression was used to examine associations between pruritus and physical and mental component summary scores, with lower scores indicating poorer quality of life.ResultsOf the 5658 CKDopps patients enrolled in the United States, Brazil, and France, 3780 (67%) answered the pruritus question. The prevalence of moderate-to-extreme pruritus was 24%, and more likely in older patients, women, and those with stage 5 CKD, lung disease, diabetes, and physician-diagnosed depression. In adjusted models, patients with moderate pruritus had physical and mental component summary scores 3.5 (95% confidence interval [95% CI], −4.6 to −2.3) and 2.3 (95% CI, −3.2 to −1.5) points lower, respectively, than patients without pruritus, and they also had a higher adjusted prevalence of patient-reported depression (prevalence ratio, 1.83; 95% CI, 1.58 to 2.11) and restless sleep (prevalence ratio, 1.69; 95% CI, 1.49 to 1.91) compared with patients without pruritus. These patient-reported outcomes were progressively worse with increasing severity of pruritus.ConclusionsOur findings demonstrate high prevalence of pruritus in nondialysis CKD, as well as strong associations of pruritus with poor health-related quality of life, self-reported depression symptoms, and self-reported poor sleep.

show abstract

Section: Discussionmentioning

confidence: 99%

Pruritus and Patient Reported Outcomes in Non-Dialysis CKD

Sukul¹,

Speyer

et al. 2019

CJASN

View full text Add to dashboard Cite

show abstract

“…Persistent low-grade inflammation is common among patients with chronic renal disease [32]. Moreover, malnutrition in CKD patients is associated with a proinflammatory state [33]. Malnutrition, inflammation, and atherosclerosis often coexist among patients with CKD, and each of these risk factors independently predicts outcome in these patients [34].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

Boaz

Azoulay

Schwartz

et al. 2019

Nephron

View full text Add to dashboard Cite

Background: Malnutrition is a frequently observed disorder in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). While variously defined, malnutrition is a frequently observed condition among patients on HD. Prevalence estimates of malnutrition among Israeli HD patients have not been reported. Objectives: To survey nutrition intake in Israeli HD patients; estimate malnutrition risk prevalence; identify risk factors, and characterize malnutrition risk in HD patients. Methods: A representative sample of 378 Israeli HD patients treated in hospital HD centers throughout the country were surveyed. Using the 24-h recall method, dietary intake was estimated and the chronologically corresponding biochemistry, anthropometric, and hemodynamic measures were recorded. Four categories of malnutrition risk were defined: “minimal”: body mass index (BMI) > 23 kg/m² and serum albumin > 3.8 g/dL; “mild”: BMI < 23 kg/m² and albumin > 3.8 g/dL; “moderate”: BMI > 23 kg/m² and albumin < 3.8 g/dL; “severe”: BMI < 23 k/m² and serum albumin < 3.8 g/dL. Results: Elevated malnutrition risk was identified in 175 (46.3%) study participants, who were more likely to require feeding assistance, have major comorbidities, reduced hemoglobin, and elevated C-reactive protein. Oral nutrition supplementation was prescribed to only 14.3% of patients with elevated malnutrition risk. Intradialytic parenteral nutrition was recorded for 6 patients, all of whom had moderate or severe malnutrition risk. Less than one-third of patients met the guidelines for dietary intake of energy or protein, and this did not differ across malnutrition risk groups. Discussion: Elevated malnutrition risk is a frequent finding in HD patients treated in hospital settings in Israel. Dietary intake does not meet guidelines but does not differ across malnutrition risk categories. Nutrition supplements are underused in HD patients with high malnutrition risk. There is a need to expand the survey to community HD centers.

show abstract

“…Patients with chronic kidney disease (CKD) experience altered physical conditions in many aspects, including proteinenergy wasting (PEW) [ 1 ], mineral bone disorder [ 2 , 3 ], chronic inflammation [ 4 , 5 ], and uremic toxin accumulation [ 6 , 7 ]. Previous studies have demonstrated that the metabolism of protein is involved in most of these adverse changes [ 8 , 9 ], especially the uremic toxin accumulation.…”

Section: Introductionmentioning

confidence: 99%

Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide Cohort Study

Yen

Lin

et al. 2018

Nutrients

View full text Add to dashboard Cite

Background: A beneficial effect of a ketoanalogue-supplemented low-protein diet (sLPD) in postponing dialysis has been demonstrated in numerous previous studies. However, evidence regarding its effect on long-term survival is limited. Our study assessed the long-term outcomes of patients on an sLPD after commencing dialysis. Methods: This retrospective study examined patients with new-onset end-stage renal disease with permanent dialysis between 2001 and 2013, extracted from Taiwan’s National Health Insurance Research Database. Patients who received more than 3 months of sLPD treatment in the year preceding the start of dialysis were extracted. The outcomes studied were all-cause mortality, infection rate, and major cardiac and cerebrovascular events (MACCEs). Results: After propensity score matching, the sLPD group (n = 2607) showed a lower risk of all-cause mortality (23.1% vs. 27.6%, hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.70–0.84), MACCEs (19.2% vs. 21.5%, HR 0.86, 95% CI 0.78–0.94), and infection-related death (9.9% vs. 12.5%, HR 0.76, 95% CI 0.67–0.87) than the non-sLPD group did. Conclusion: We found that sLPD treatment might be safe without long-term negative consequences after dialysis treatment.

show abstract

Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients

Cited by 55 publications

References 19 publications

Pruritus and Patient Reported Outcomes in Non-Dialysis CKD

Pruritus and Patient Reported Outcomes in Non-Dialysis CKD

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide Cohort Study

Contact Info

Product

Resources

About