Nutrition in Kidney Failure

2020 ◽  
Author(s):  
Serpil Muge Deger ◽  
T. Alp Ikizler
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Hemodialysis ◽  
Protein Energy Wasting ◽  
Risk Of Death ◽  
Protein Energy ◽  
Stage Renal Disease ◽  
End Stage

Among the many factors that affect outcome in patients with chronic kidney disease (CKD), a state of metabolic and nutritional derangements, more aptly called protein-energy wasting (PEW) CKD, plays a major role.1 Multiple studies now indicate that PEW is highly prevalent and is closely associated with important clinical outcomes, such as hospitalizations and risk of death in this patient population. The focus of this review is to provide an overview of nutrition and metabolism in all stages of CKD, including end-stage renal disease (ESRD). This review contains 3 figures, 5 tables, and 105 references.  Key words: chronic-kidney disease (CKD), dialysis, end stage renal disease (ESRD), inflammation, maintenance hemodialysis (MHD), protein-energy wasting (PEW),uremia  

scholarly journals Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 326
Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Root Canal ◽  
Dialysis Patients ◽  
Root Canal Therapy ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

scholarly journals Frequency of Ischemic Heart Disease in Patients of End Stage Renal Disease

2021 ◽  
Vol 15 (7) ◽  
pp. 2059-2061
Author(s):  
Muhammad Farhan Akhtar ◽  
Hafiz Muhammad Waqas Siddque ◽  
Talha Nazir ◽  
Ubaid Khan
Keyword(s):  
Chronic Kidney Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Ischemic Heart Disease ◽  
End Stage Renal Disease ◽  
Ischemic Heart ◽  
Maintenance Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage

Introduction: The disease burden of Chronic Kidney Disease (CKD) is increasing every day and adding the burden on our healthcare system. Many patients are being treated by hemodialysis due to a very limited recourses available. Cardiovascular complications such as ischemic heart disease (IHD) are very common in patients who are being treated by hemodialysis and one of the leading causes of death in these patients. Objective: Frequency of IHD in the patients of ESRD. Methodology: Cross-sectional type of study was piloted for duration of three months from April 2019 to June 2019 in Nephrology Department Mayo Hospital Lahore. Eighty one patients were recruited who fulfilled the inclusion criteria i.e. patients suffering end stage renal disease on maintenance hemodialysis through non-probability, convenient sampling. A standard questionnaire was used to collect the data. All the data was analyzed by using SPSS (software package for statistical analysis) version 20. Results: The study was carried out among 81 patients with diagnosis of Chronic Kidney Disease on the maintenance hemodialysis. Most patients in study were falling in the range of 21-60 years. The study included 46 (56.8%) males and 35(43.2%) females. The frequency of Ischemic Heart Diseases in these patients was found to be 56.8% (46/81 cases). Conclusion: Both genders are equally affected. The frequency of IHD in patients of end stage renal disease who are on hemodialysis is observed to be high, but not as much high as observed in previous studies. Both genders are affected almost equally. Key Words: Ischemic Heart Disease, End stage renal disease, chronic kidney disease, Hemodialysis

scholarly journals Can Overnutrition Lead to Wasting?—The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 247
Author(s):  
Krzysztof Hoppe ◽  
Krzysztof Schwermer ◽  
Mikołaj Dopierała ◽  
Małgorzata Kałużna ◽  
Anna Hoppe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Hemodialysis ◽  
Protein Energy Wasting ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Background: The population of end-stage renal disease (ESRD) patients with diabetes mellitus (DM) may be at increased risk of protein energy wasting (PEW). The aim of the study was to investigate the impact of DM on selected indicators of PEW in the ESRD population that was undergoing maintenance hemodialysis (MHD). Methods: A total of 515 MHD patients were divided into two subgroups with and without DM. The evaluation of diet composition, Charlson Comorbidity Index (CCI), SGA, and laboratory and BIS analyses were performed. All-cause and cardiovascular mortality was recorded. Results: DM patients had lower albumin (3.93 (3.61–4.20) vs. 4.10 (3.80–4.30) g/dL, p < 0.01), total cholesterol (158 (133–196) vs. 180 (148–206) mg/dL, p < 0.01), and creatinine (6.34 (5.08–7.33) vs. 7.12 (5.70–8.51) mg/dL, p < 0.05). SGA score (12.0 (10.0–15.0) vs. 11.0 (9.0–13.0) points, p < 0.001), BMI (27.9 (24.4–31.8) vs. 25.6 (22.9–28.8) kg/m2, p < 0.001), fat tissue index (15.0 (11.4–19.6) vs. 12.8 (9.6–16.0) %, p < 0.001), and overhydration (2.1 (1.2–4.1) vs. 1.8 (0.7, 2.7) L, p < 0.001) were higher in the DM group. Increased morbidity, reflected in the CCI and mortality—both all-cause and cardiovascular—were observed in DM patients. Conclusions: Hemodialysis recipients with DM experience overnutrition with a paradoxically higher predisposition to PEW, expressed by a higher SGA score and lower serum markers of nutrition. This population is also more comorbid and is at higher risk of death, including from cardiovascular causes.

scholarly journals Neurophysiological and Neuroradiological Changes in children with chronic kidney disease

2020 ◽  
Author(s):  
Sameh Abd El Naby ◽  
Ali El-Shafie ◽  
Wael Bahbah ◽  
Asmaa Mahmoud
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Pediatric Nephrology ◽  
Neurological Complications ◽  
Maintenance Hemodialysis ◽  
Axonal Polyneuropathy ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Patients with chronic kidney disease on hemodialysis are frequently afflicted with neurological complications. These complications can potentially affect both the central and peripheral nervous systems. Common neurological complications in CKD include stroke, cognitive dysfunction, and encephalopathy, peripheral and autonomic neuropathies.Aim: to detect the neurological manifestations and complications in children with chronic kidney disease through neurophysiological and neuro-radiological findings.Methods: The study included 50 patients with CKD admitted to pediatric nephrology unit. Their history, complete physical and neurological examination finding had been recorded. All of them underwent nerve conduction, electromyography (EMG), electroencephalography (EEG) and magnetic resonance imaging (MRI).Results: Included children were 23 males and 27 females with mean age of (12.8±3.44 year). 11 (22%) patients of end stage renal disease developed polyneuropathy mostly of axonal polyneuropathy pattern while 78% of them showed normal electrophysiological studies. No myopathy was detected. Abnormal electroencephalography findings were detected in 18% of patients in the form of generalized and focal (temporal, occipital and frontal) epileptogenic activity had been found. Abnormal MRI findings were detected in 16% of patients mostly of encephalomalachia. Conclusion: Neurological status in patients with end stage renal disease on maintenance hemodialysis therapy was impaired. Uremic neuropathy is highly prevalent in these patients. They developed polyneuropathy mostly of axonal polyneuropathy pattern. EEG is a useful tool for detection of subclinical or latent uremic encephalopathy and/or epileptogenic activity. Early detection and management of these neurological conditions may estimate a window to reduce physical disability in children with CKD.

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