Prevalence of Protein-energy Wasting and Its Various Types in Iranian Hemodialysis Patients: A New Classification

Abstract

Background: This study was designed to determine the prevalence of protein-energy wasting (PEW) and its various types in hemodialysis (HD) patients in Tehran, Iran. Methods: For this cross-sectional study, 291 HD patients were randomly selected. The nutritional status of the patients was determined by subjective global assessment (SGA) and their dietary intakes were assessed using a 4-day dietary recall. In addition, serum high-sensitive C-reactive protein (hs-CRP) was measured. Results: The prevalence of mild-to-moderate and severe PEW based on SGA was 60.5% and 1% in Tehran HD patients, respectively. The prevalence of various types of PEW in HD patients was 20.5% type I (inadequate energy or protein intake without inflammation), 65.5% type IIa (inadequate energy or protein intake with inflammation), and 14% type IIb (adequate energy and protein intake with inflammation). Of the total HD patients with no PEW based on SGA, about 3.5% had type 0 normal nutritional status (adequate energy and protein intake without inflammation), 34% had type I normal nutritional status (inadequate energy or protein intake without inflammation), 55.5% had type IIa normal nutritional status (inadequate energy or protein intake with inflammation), and 7% had type IIb normal nutritional status (adequate energy and protein intake with inflammation). Conclusion: PEW in Tehran HD patients is considerably prevalent and PEW type IIa is the most common type. In addition, HD patients with no PEW based on SGA should also be paid attention because they may be in the early stages of inadequate intake of energy and/or protein and inflammation.

Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients

“…Our study showed that the prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8%, respectively, in adult PD patients in peritoneal dialysis centers in Tehran, Iran. The reason for this low prevalence of obesity, including dynapenic obesity and sarcopenic obesity, in Iranian PD patients is a high prevalence of protein-energy wasting in dialysis patients in Iran [26]. We found no study on the prevalence of dynapenic obesity in CKD patients, including PD patients, to compare with the results of our study.…”

Assessment of nutritional status in maintenance hemodialysis patients: A multicenter cross‐sectional study in Iran

“…This finding is in agreement with those of smaller studies in Iran. Tabibi et al, in a study from Tehran‐Iran, showed that 60.5% of HD patients had mild‐to‐moderate PEW and 1% had severe PEW 24 . In the study by Saran et al, the prevalence of mild‐to‐moderate and severe PEW was 24% and 8%, respectively 25 .…”

Comparison between direct and indirect methods to diagnose malnutrition and cardiometabolic risk in haemodialisys patients

“…Protein‐energy malnutrition (PEM) is highly prevalent in individuals undergoing haemodialysis (HD) because of a reduced protein and energy intake, inflammation, resistance to anabolic hormones such as insulin and growth hormone, and the loss of amino acids and other nutrients in the dialysate and catabolism of muscle protein .…”