Malnutrition, Anthropometric, and Biochemical Abnormalities in Patients With Diabetic Nephropathy

Khan, Sakina; Chandanpreet, Sandhu; Krishan, Kewal; D’Cruz, Sanjay; Ram, Kashyap Jeet; Sachdeva, Atul

doi:10.1053/j.jrn.2009.01.026

Cited by 13 publications

(3 citation statements)

References 45 publications

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“…In the TB-DM subgroup, we found two major positive predictors for death: male gender and malnutrition. Malnutrition was previously found to be highly prevalent in elderly diabetic patients and those with diabetic renal complication [36][37][38] and was identified in our model as a strong predictor for death in the TB-DM subgroup. In contrast, it is intriguing that an initial positive AFB smear was identified as a negative predictor for death in TB-DM patients.…”

Section: Discussionmentioning

confidence: 76%

Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico

Abdelbary¹,

García

Ramirez-Oropesa

et al. 2017

Epidemiol. Infect.

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The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use. Modified risk scores were developed with strong predictability for treatment failure and death (c-statistic 0·65 and 0·70, respectively), and moderate predictability for drug resistance (c-statistic 0·57). Among TB patients with diabetes, risk scores showed moderate predictability for death (c-statistic 0·68). Our findings suggest that in the clinical setting, the use of our risk scores for TB treatment failure or death will help identify these individuals for tailored management to prevent these adverse events. In contrast, the available variables in the TB surveillance dataset are not robust predictors of drug resistance, indicating the need for prompt testing at time of diagnosis.

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Section: Discussionmentioning

confidence: 76%

Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico

Abdelbary¹,

García

Ramirez-Oropesa

et al. 2017

Epidemiol. Infect.

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“…[78][79][80] Similarly, patients with diabetes and CKD are at a higher risk of malnutrition and weight loss if dietary protein restriction is instituted. 19,81 Unfortunately, being overweight or obese also predisposes diabetics to becoming frail.…”

Section: Body Mass Indexmentioning

confidence: 99%

Frailty in Pancreas Transplantation

et al. 2021

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INTRODUCTIONIn recent years, frailty has received increasing attention in various areas of medicine. [1][2][3] Although various previous definitions of frailty were similar to the definition of disability, comorbidities, or advanced age, frailty is not synonymous with those conditions. 4 Geriatricians define frailty as a biologic syndrome of decreased reserve and resistance to stressors that results from cumulative declines across multiple physiologic systems, leading to vulnerability to adverse outcomes. 4 In the absence of a gold-standard definition of frailty, it has been operationally defined by Fried et al 4 as meeting 3 out of 5 phenotypic criteria indicating compromised energetic: low grip strength, low energy, slowed walking speed, low physical activity, and unintentional weight loss. 5 Frailty is a common problem in various solid organ transplant candidates who are in the process of being listed for a transplant, as well as after transplantation. [6][7][8][9][10] Even after adjusting for the multiple confounding factors, frail patients are less likely to be listed for kidney transplantation, less likely to get a transplant, and more likely to die on the waitlist. 10 Other complications of frailty include increased length of hospital stay, readmission, delayed graft function, and many more (Figure 1). 11 Patients with diabetes or chronic kidney disease (CKD) are known to be at increased risk of being frail. 12,13 Risk factors for frailty include older age, low education level, intellectual disability, depression, unmarried status, current cigarette smoker, use of postmenopausal hormone therapy, and being African American. [14][15][16][17][18] Transplant programs use different tools and criteria to assess frailty among possible organ recipients. In a recent survey from the United States, among 133 kidney transplant programs that responded to the survey, McAdams-DeMarco et al 11 found 19 different tools/criteria used by kidney transplant programs to assess for frailty-these are summarized in Table 1.Pancreas transplant recipients are in a unique situation, where all patients would have diabetes for a prolonged period. In addition, the majority of them would also have CKD, requiring both pancreas and kidney transplantation. Here, we review clinically relevant information about frailty, including prevalence, risk factors, assessment tools, and impacts, as it relates to pancreas transplant recipients, both

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“…Albuminuria on turn strongly predicts adverse clinical outcomes and mortality in T2DM [2,3]. Furthermore, albuminuric T2DM patients often exhibit a cluster of metabolic and nutritional abnormalities linked both to the metabolic disease and to kidney failure, including insulin resistance [4], cardiovascular comorbidities [5], poor nutritional status [6], decreased lean body mass [7] and sarcopenia [8]. Albuminuric T2DM patients may also exhibit hypoalbuminemia and decreased/altered concentrations and turnover of plasma proteins [9,10].…”

Section: Introductionmentioning

confidence: 99%

Accelerated whole-body protein catabolism in subjects with type 2 Diabetes Mellitus and albuminuria

et al. 2020

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Background Albuminuria develops in ~40% of subjects with Type 2 Diabetes Mellitus (T2DM), and is often associated with malnutrition, severe comorbidities and decreased life expectancy. The association between albuminuria and altered whole body protein turnover in T2DM is currently unknown. Objective To assess whole body protein degradation and synthesis in type 2 diabetes with and without albuminuria. Methods Fourteen T2DM male subjects, with either increased [AER+] or normal [AER-] urinary albumin excretion rate, and eleven age-matched male healthy controls, were infused with phenylalanine [Phe] and tyrosine [Tyr] tracers. Post-absorptive rates of appearance (Ra) of Phe (= protein degradation) and Tyr, Phe hydroxylation to Tyr (Hy) (catabolic pathway), and Phe disposal to protein synthesis [PS], were determined. Results Phe and Tyr Ra were not different among the groups. However, in T2DM [AER+], the fraction of Phe disposal to hydroxylation was ~50% and ~25% greater than that of both controls and T2DM [AER-] (p<0.006 and p = 0.17, respectively). Conversely, as compared to controls, the fractional Phe disposal to PS was ~10% lower in T2DM [AER+] (p<0.006), and not different from that in T2DM [AER-]. As a consequence, in T2DM [AER+], the ratio between the fractional Phe disposal to hydroxylation and that to PS was ~70% greater (p = 0.005) than that in healthy controls, whereas in the T2DM [AER-] this ratio was ~30% greater than in controls (p = 0.19). Conclusions On the basis of the kinetics of the essential amino acid phenylalanine, T2DM subjects with increased AER exhibit a catabolic pattern of whole body protein turnover.

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Malnutrition, Anthropometric, and Biochemical Abnormalities in Patients With Diabetic Nephropathy

Cited by 13 publications

References 45 publications

Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico

Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico

Frailty in Pancreas Transplantation

Accelerated whole-body protein catabolism in subjects with type 2 Diabetes Mellitus and albuminuria

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