Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study

Adanan, Nurul Iman Hafizah; Ali, Mohamed Abdullahi; Lim, Jun Hao; Zakaria, Nor Fadhlina; Lim, Christopher Thiam Seong; Yahya, Rosnawati; Gafor, Abdul Halim Abdul; Karupaiah, Tilakavati; Daud, Zulfitri Azuan Mat

doi:10.1053/j.jrn.2019.06.003

Cited by 20 publications

(32 citation statements)

References 43 publications

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“…Generally, overreporting is not common in HD patients, and in healthy individuals during R; higher calorie intake may actually be prevalent [4,36,37]. Adanan et al [29] noted no over-reporting in food intake. We therefore analyzed data only for under-reporters, with a ratio of EIrep/TEE <0.76 being used as the cut-off for under-reporting of EIrep [36].…”

Section: Methodsmentioning

confidence: 99%

“…The impact or association of any nutritional changes with changes in anthropometric or blood chemistry (including lipids) is largely unexplored. Recently Adanan et al [29] reported on nutritional and anthropometric changes in Malaysian subjects before, during and after R. Although temporal changes in some nutritional parameters were noted, none were considered detrimental.…”

Section: Introductionmentioning

confidence: 99%

“…There is however limited information available on alterations in plasma lipids [30] during the period of R in HD patients. Wan Md Adnan et al [30] noted decreased low-density lipoprotein cholesterol (LDL-C) concentrations at the end of R in diabetic HD patients, while Adanan et al [29] reported no effects on LDL-C. Mixed results have also been obtained in healthy individuals where increased LDL-C and lower TAG [15], or no effects on LDL-C [31] or decreased LDL-C [29,32] have been observed during the R period. In contrast, a meta-analysis in healthy subjects during R found a significant reduction in LDL in both genders, a significant reduction in total cholesterol and TAG amongst males and a significant increase in HDL-C among females [16].…”

Section: Introductionmentioning

confidence: 99%

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Lipids, Lipoprotein Distribution and Nutritional Parameters over the Ramadan Period in Hemodialysis Patients

et al. 2019

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The period of Ramadan (R) is associated with dramatic changes in eating habits involving extended periods of fasting on a daily basis. The current study assessed whether lipids and lipoproteins were impacted during R in chronic hemodialysis (HD) patients. Forty-five subjects in an outpatient dialysis clinic in Saudi Arabia were evaluated for anthropometric and lipid changes on a monthly basis before, during as well as one and two months after R. In addition to routine biochemical measures, anthropometric assessments including hand-grip strength (HGS), mid-arm muscle circumference (MAMC), plasma lipids and lipoproteins were evaluated. Dietary assessment was carried out using 24 h recalls. Over the course of the study, changes in renal-related parameters (creatinine, albumin, Kt/V) were minor, as were changes in plasma lipids. Large high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs) accounted for the majority of their respective lipoproteins and their proportions did not change over the study period. Mean LDL particle diameters were higher during the R period, but the changes over the study period were small. Calorie intake during R (2139 ± 709 kcal/d) was significantly higher than the value noted two month post-R (1755 ± 424 kcal/d) and this was associated with significant increases in protein (69 ± 24 vs. 60 ± 24 g/d) and fat (97 ± 38, vs. 73 ± 35 g/d), respectively. No changes were noted with respect to HGS and MAMC. These data show that for HD patients, the period of R results in temporal or non-significant effects on plasma lipids, despite changes in nutrient intake.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lipids, Lipoprotein Distribution and Nutritional Parameters over the Ramadan Period in Hemodialysis Patients

et al. 2019

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“…Routine blood tests assessed in this study included renal function test i.e., serum urea, creatinine, potassium, and phosphate. Briefly, serum urea was determined using urease-kinetic method, creatinine by Jaffee rate blanked compensated method, phosphorus by molybdate reagent method and potassium by enzymatic method using Cobas 6000 (Roche, Germany) as previously reported [ 27 ]. The assessment of these biomarkers was used as additional reference markers to validate the HD-FFQ.…”

Section: Methodsmentioning

confidence: 99%

HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population

et al. 2020

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A rapid and reliable tool appropriate to quantifying macronutrient and micronutrient intakes in diets consumed by Malaysian hemodialysis (HD) patients is lacking. We aimed to develop and validate a novel HD-food frequency questionnaire (HD-FFQ) to assess habitual nutritional intakes of HD patients with diverse ethnic backgrounds. This study was conducted in three phases. In Phase I, a HD-FFQ comprising 118 food items was developed using 3-day diet recalls (3DDR) from 388 HD patients. Phase II was the face and content validation using the Scale-Content Validity Index (S-CVI). After successfully developing the FFQ, Phase III tested relative validation against a reference method, the 3DDR. Results from Phase III showed that the mean difference for absolute intakes of nutrients assessed by HD-FFQ and 3DDR were significant (p < 0.05). However, there was a significant correlation between the HD-FFQ and reference method ranging from 0.35–0.47 (p < 0.05). Cross-quartile classification showed that <10% of patients were grossly misclassified. In conclusion, the HD-FFQ has an acceptable relative validity in assessing and ranking the dietary intake of the HD patients in Malaysia.

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“…Psychosocial factors may negatively impact physical and emotional status, QoL, and nutritional status in HD patients [ 149 , 191 , 192 ], as shown in Table 8 .…”

Section: Non-iatrogenic Causes Of Malnutritionmentioning

confidence: 99%

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Sahathevan

Khor

et al. 2020

Nutrients

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Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

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Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study

Cited by 20 publications

References 43 publications

Lipids, Lipoprotein Distribution and Nutritional Parameters over the Ramadan Period in Hemodialysis Patients

Lipids, Lipoprotein Distribution and Nutritional Parameters over the Ramadan Period in Hemodialysis Patients

HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

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