Nutritional Status Of Hemodialysis Patients Research Articles

Effect of Nutritional Status and Haemodialysis Parameters on Health Related Quality of Life and Post Dialysis Recovery Time in Prevalent Haemodialysis Patients

Abstract Background The majority of patients with an impaired renal function may be classified as to a certain stage of chronic kidney disease (CKD) progressing to end-stage renal disease (ESRD) and requiring renal replacement therapy (RRT). Aim of the Work To study the effect of current nutritional status of haemodialysis patients and other variables (socio-demographic, physical, biochemical and dialysis treatment parameters) on health related quality of life and post dialysis recovery time among haemodialysis patients in haemodialysis units in Desouq general hospital, Kafr-Elshiekh Governorate. Patients and Methods Type of Study: We conducted an observational cross-sectional study. Study Setting: The study was conducted in haemodialysis units in Desouq general hospital, Kafr-Elshiekh governorate. Study Period: from July to September in 2021. Study Population: 100 prevalent End Stage Renal Disease (ESRD) patients on regular haemodialysis 3 times per week in Desouq general hospital. Results The result of this study concluded that the factors affecting nutritional status for those patients were age & dialysis wintage, serum HB, serum calcium, both serum albumin & serum pre-albumin, intake of: (carbohydrate, potassium, calcium, phosphorous & magnesium) & anthropometric measurement of; (Weight, BMI, calf circumference, BSF, TSF, MAMC & MAC). Also, our study concluded that the factors affecting QOL for our patients were; SGA score (as a surrogate for nutritional status), duration of session, serum albumin & prealbumin, height, MAC, MAMC &calf circumference. Patients with poor nutrition have a poor physical and mental quality of life. Hence, it becomes important (not only for us but also for them) to identify such patients and intervene earlier, in order to improve their quality of life and also reduce morbidity which in turn helps in reducing mortality. Conclusion Malnutrition is one of the most commonly encountered (&treatable) problems in haemodialysis population in Egypt as it increases the morbidity and mortality. SGA (M- SGAS) and HRQOL SF 36 (Kidney Disease and Quality of Life--Short Form (KDQOL- SF™) version 1.3) are simple to use, bedside and readily available tools for nutritional & QOL assessment of MHD patients, respectively.

#1530 Studying parenteral nutrition in patients with dialysis stage chronic kidney disease

Abstract Background and Aims Hemodialysis is associated with high rates of morbidity and mortality, as well as poor quality of life. Changes in nutritional status and loss of protein and energy are important indicators of these risks. Maintaining optimal nutritional status in hemodialysis patients is an important but sometimes overlooked aspect of treatment. In some cases, intradialytic parenteral nutrition is possible, but lack of knowledge about the practical aspects of administration is rarely discussed. The purpose of our study was to study the age-related characteristics of the nutritional status in patients with CKD of the dialysis stages who are on parenteral nutrition. Method The study included 40 patients with stage C5 CKD. Glomerular filtration rate (eGFR) was estimated using the CKD-EPI formula (2011) [11]. Anthropometric data were studied: height, weight, body mass index (BMI), mid-thigh circumference and mid-upper arm circumference, as well as laboratory data: urea, creatinine, electrolytes, albumin, total protein, hemoglobin. All patients underwent instrumental research methods: ECG, EchoCG. The patients were divided into 2 groups – with and without PEM. Statistical data processing was carried out according to standard methods using a computer program package. Results Total body water (TBW) (P = 0.026) and triceps skinfold thickness (P < 0.05) were higher in the hemodialysis group. BMI and other anthropometric parameters showed no significant differences between the two groups. Total caloric intake (P < 0.05) and total cholesterol (P < 0.05) were higher in patients with PEM. Intake of other nutrients, including proteins, lipids, microelements and vitamins, did not show significant differences between the two groups. Only 24% of patients were malnourished. Triglyceride levels were higher in non-malnourished patients, but HDL levels were higher in malnourished patients. Some anthropometric indicators were significantly higher in patients not suffering from PEM. It is worth noting that malnourished patients consumed more calories and nutrients, including proteins, plant lipids, animal lipids and carbohydrates. Conclusion Compared with malnutrition patients and non-malnutrition patients, several anthropometric parameters, including subiliac skinfold thickness and MAC, were significantly lower in the malnutrition group. These values can be measured using simple methods and are used as a useful method for assessing malnutrition. Interestingly, patients with malnutrition and lower BMI albumin actually consumed more calories and nutrients from food. This means that malnutrition in dialysis patients is not simply caused by low food intake.

Providing Intradialytic Parenteral Nutrition Therapy Does Not Improve Anthropometric Status in Hemodialysis Patients with Malnutrition

Background: Malnutrition is prevalent in hemodialysis patients and significantly impacts prognosis. It can result from reduced food intake and protein loss during hemodialysis. Nutritional status is determined through anthropometric examinations, which include upper arm circumference (UAC), body mass index (BMI), hand grip strength, bicep, and tricep fold thickness. Laboratory examinations like total cholesterol and Malnutrition Inflammation Score (MIS) or Subjective Global Assessment (SGA) are also used. Intradialytic Parenteral Nutrition (IDPN) is expected to maintain or improve the nutritional status of hemodialysis patients. Objective: This research examines the impact of parenteral nutrition therapy on the anthropometric status of malnourished hemodialysis patients. Methods: This cross-sectional study, a sub-analysis of a larger nutritional therapy study, involved 24 hemodialysis patients experiencing malnutrition based on SGA B and C criteria with 1-10 years of hemodialysis. IDPN therapy was provided, and anthropometric measurements and total cholesterol were taken at baseline and three months after nutritional therapy. Data processing used comparative statistical analysis. Results: The mean age was 45.33 years, with 14 males and 10 females. After 3 months, there were no significant differences in UAC (mean difference = 0.13; p = 0.69), BMI (mean difference = 0.13; p = 0.50), hand grip strength (mean difference = -0.96; p = 0.282), biceps skinfold thickness (mean difference = 0.13; p = 0.69) and triceps (mean difference = 0.59; p = 0.134) or total cholesterol (mean difference = -1.5; p = 0.71). Conclusion: IDPN therapy for 3 months did not improve the anthropometric status of hemodialysis patients with malnutrition.

Effects of Dietary Protein Restriction on Nutritional Status of Hemodialysis Patients

Haemodialysis is one of the three renal replacement therapies in which waste products and excess fluid are removed from blood when kidneys stop functioning properly. Protein catabolism is increased as patients lose some protein during haemodialysis treatment. Sufficient protein intake is of great significance, yet prevalence of inadequate protein consumption persists due to various reasons, resulting protein-energy malnutrition (PEM). The studies regarding low protein intake among haemodialysis patients is lower compared to studies conducted on non-dialysis chronic kidney disease (CKD) patients. The purpose of this study was to investigate the prevalence of protein restriction practices and its effect in nutritional status of haemodialysis patients. The study was descriptive exploratory analysis among 150 haemodialysis patients at one of the largest dialysis center of Kathmandu district using anthropometric, biochemical, clinical and dietary (ABCD) assessments. Among 150 haemodialysis patients, majority (63.3%) were male. 71.3% were undergoing haemodialysis for more than 1 to 5 years and 82.7% doing twice a week in- center haemodialysis. According to serum albumin report, 66.7% were identified as PEM. Body mass index (BMI) result also classified 3.3% as underweight. It was concluded that the effect of protein restriction resulted as malnourished among certain patients. The underlying causes for consuming low protein diets were associated with dislike to protein-rich foods, financial constraints, lack of awareness, and other factors. Establishing regular consultations with dieticians and closely monitoring dietary patterns appeared as crucial approaches for enhancing the nutritional status of these patients. It is essential to acknowledge that protein requirements vary based on different stages of CKD and the presence of concurrent health conditions. Consistent follow-up by a multidisciplinary team, utilizing a range of nutrition assessment methods specified for haemodialysis patients is vital step.

Nutritional status in hemodialysis patients with kidney failure during the COVID-19 pandemic - a one centre experience

Nutritional status in hemodialysis patients with kidney failure during the COVID-19 pandemic - a one centre experience

Adipokines, myokines, and nutritional status in hemodialysis patients

Adipokines, myokines, and nutritional status in hemodialysis patients

Hemoglobin Variability Is Associated with Nutritional Status in Hemodialysis Patients Undergoing Darbepoetin-Alfa Treatment

Hemoglobin Variability Is Associated with Nutritional Status in Hemodialysis Patients Undergoing Darbepoetin-Alfa Treatment

Study of the Relationship between Serum Adropin Level and Nutritional Status in Hemodialysis Patients

Study of the Relationship between Serum Adropin Level and Nutritional Status in Hemodialysis Patients

Association of extracellular water/total body water ratio with protein-energy wasting and mortality in patients on hemodialysis

Bioimpedance analysis-assessed extracellular water/total body water (ECW/TBW) ratio may be a marker for mortality and poor nutritional status in hemodialysis patients. In 193 maintenance hemodialysis patients, we retrospectively investigated the relationships among ECW/TBW ratio, mortality, and protein-energy wasting (PEW). Four components—body mass index, normalized protein catabolic rate, normalized serum creatinine level, and serum albumin level—constitute the simple PEW score; this score was calculated based on the positive number of items concerning malnutrition among these four components. A score ≥ 3 indicated PEW. Patients were stratified by an ECW/TBW ratio cut-off value (0.40) and by PEW versus non-PEW status. The simple PEW score, cardiothoracic ratio, and log-transformed C-reactive protein level were independently correlated with the ECW/TBW ratio. Eighty-four patients died during follow-up (median 4.3 years). After adjustments for sex, age, hemodialysis vintage, histories of cardiovascular events and diabetes, and C-reactive protein level, a higher ECW/TBW ratio and PEW were independently related to elevated risks of all-cause death. Adding the ECW/TBW ratio to a baseline risk model including PEW significantly increased C-statistics from 0.788 to 0.835. In conclusion, the ECW/TBW ratio may be an indicator of PEW and may be a predictor of death even accounting for PEW, in hemodialysis patients.

Could cooling dialysate improve inflammatory and nutritional status of hemodialysis patients?

BackgroundIt has been shown that dialysate cooling (lowering the dialysate temperature to 0.5 °C below central body temperature) reduces the incidence of intradialytic hypotension. Other influences on hemodialysis patients, however, have not been adequately investigated. The purpose of this study was to determine the impact of individualized dialysate cooling on nutritional and inflammatory parameters in chronic hemodialysis (HD) patients.MethodsSeventy HD patients were separated into two groups: group A: (control group) standard dialysate temperature was 37 °C, and group B: (intervention group) dialysate temperature was 0.5 °C below core body temperature. In addition to routine laboratory tests, blood pressure, anthropometric measurements, inflammatory markers, and the malnutrition inflammation score (MIS) were calculated.ResultsAfter six months of dialysate cooling, intradialytic hypotension episodes were much less prevalent in the intervention group (p = 0.001). Serum ferritin, transferrin saturation (TSAT), high sensitive C-reactive protein (HS-CRP), and Interleukin-6 (IL-6) reduced following dialysate cooling, whereas serum albumin rose. In the control group, IL-6 dropped but serum ferritin, TSAT, albumin, and HS-CRP rose. In both groups, hemoglobin levels dropped, and erythrocyte sedimentation rate (ESR) rose, both groups’ midarm muscle circumference and MIS worsened.ConclusionCold dialysate decreased intradialytic hypotension with no significant improvement of the nutritional and inflammatory surrogates. However, more studies including larger number of patients with longer duration of follow up are required to adequately assess its effect on inflammation and nutrition in chronic hemodialysis patients.

Hand Grip Strength: A Tool of Nutritional Assessment in Prevalent Hemodialysis Patients

Abstract Background Malnutrition is a common problem in patients with end stage renal disease (ESRD) undergoing hemodialysis that is associated with increased morbidity and mortality. There are several clinical, nutritional, and biochemical parameters that may be indicative of PEW in patients using hemodialysis (HD). Handgrip strength is a simple, quick, non-invasive, inexpensive, rapid, and objective procedure. In addition, it has other advantages as a diagnostic/screening tool for nutritional assessment. However, HGS relies on the motivation of the subjects, and therefore it is imperative that researchers and clinicians are sufficiently trained in HGS assessment. L-Carnitine supplementation, levocarnitine is an amino acid derivative which is an essential cofactor of fatty acid metabolism, may improve several situations. Aim of the Work The aim of our study, a longitudinal observational study, is to assess HGS as an independent tool for assessment of the nutritional status in hemodialysis patients. This study can also show the significance of the commitment to high protein diet (1.2-1.4 g/ kg/ d) and receiving L-carnitine (10-20 mg/kg intravenously after each dialysis session) and its effect on the handgrip strength and other studied nutritional tools. Patients and Methods In our study, a longitudinal observational study, study duration was 3 months after washout period; our population is all End Stage Renal Disease patients in Kasr AlAiny Hemodialysis Unit, Cairo University. The unit provides hemodialysis and medical service for 104 patients from whom 50 were excluded and 54 patients were enrolled. Results the study showed comparison between both studied groups regarding the studied laboratory parameters and different nutrition assessment tools showed no statistically significant differences. The study showed Comparison between the effect of high protein diet and L Carnitine (pre and post) in patients of group B on the studied nutritional tools and laboratory parameters. Again HGS was the only tool that showed statistical significance. %BF(body fat) assessed by anthropometry was negativelycorrelated with HGS. Also they found lower HGSvalues in patients on HD with higher estimates of abdominal fatdeposition. Thus, it seems that low muscle mass can occurdespite fat accumulation, and one possible explication for thiswould be the proinflammatory phenotype presented by individualswith abdominal fat deposition. This confirms that subjects can have normal or higher BMI and have a depletionprocess, thus increasing the need for screening proceduresrelated to functional status. Conclusion In this study, we concluded that HGS was the only significant (p value: <.001), while all other nutrition assessment tools didn’t show any significant difference.The correlation between nPCR and HGS was statistically significant (p value:.001, r:.616). L-carnitine supplementation has no role over commitment to high protein diet only regarding improving the nutritional status and hemoglobin level in hemodialysis patients.

Simple Objective Assessment to Determine Nutritional Status of Hemodialysis Patients

Objective: The objective is to determine nutritional status of hemodialysis (HD) patients using simple objective assessment (SOA) method. Methods: A total of 54 stable patients were evaluated at our dialysis center. All patients were undergoing maintenance HD for at least 6 months. Nutritional status was assessed by subjective global assessment (SGA) and SOA which included two parameters, i.e., change over past 6 months in weight and albumin. Results: The SGA scoring showed that 39 (72.22%) patients were well nourished, 14 (25.92%) mild to moderately malnourished, and 1 (1.85%) severely malnourished. Using the SOA scoring, 40 (74.07%) patients were well nourished, 13 (24.07%) mild to moderately malnourished, and 1 (1.85%) severely malnourished. There was good correlation between the two scoring methods with a correlation coefficient (R) of 0.85. Conclusion: Our study shows that SOA using delta weight and delta albumin over 6 months provides as good information as SGA (R = 0.85) and is easy to implement in routine clinical practice.

Serum Adropin Levels in Relation to Nutritional Status in Hemodialysis Patients

Serum Adropin Levels in Relation to Nutritional Status in Hemodialysis Patients

The Humoral Response to SARS-CoV-2 Vaccine in Hemodialysis Patients Is Correlated with Nutritional Status.

Hemodialysis patients are highly susceptible to poor nutritional status. Our objective was to investigate whether poor nutritional status during mRNA-SARS-CoV-2 vaccination is correlated with impaired vaccine responses. This retrospective study was conducted in two hospital-based dialysis units. The nutritional status of hemodialysis patients was assessed, using a malnutrition inflammation score (MIS) at the time of their first BNT162b2 vaccine dose. One month after the second vaccine dose, we performed a quantitative assessment of antibodies against the spike protein (anti-S1 IgG). A total of 115 hemodialysis patients, with an average age of 72 were enrolled in the study. Among them, 39 (33.9%) were female, and 67 (58.2%) had diabetes mellitus. In 43/115 (37.4%) patients, moderate to severe malnutrition (MIS > 5) was detected. Comparatively, malnourished patients showed a lower log-transformed mean level of anti-S1 IgG compared to those with normal nutrition (2.91 ± 0.83 vs. 3.25 ± 0.72, respectively, p = 0.024). In a multivariable analysis that adjusted for age, sex, and KT/V, the nutritional status assessed by an MIS remained inversely associated with an anti-S1 IgG response [B; -0.066 (-0.117 to -0.015)]. In conclusion, moderate to severe malnutrition in hemodialysis patients is associated with reduced humoral responses to BNT162b2 vaccination.

#2621 HEMOGLOBIN VARIABILITY IS ASSOCIATED WITH NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS UNDERGOING DARBEPOETIN-ALFA TREATMENT

Abstract Background and Aims Anemia is the most common finding in hemodialysis (HD) patients. A significant proportion of patients are taking erythropoietin (EPO) or other erythrocyte-stimulating agents (ESAs), yet the response to treatment is unsatisfactory, and EPO responsiveness is inconsistent in HD patients. Further, although the introduction of EPO has led to a dramatic reduction in blood transfusion requirements and is associated with improved quality of life, fluctuations in hemoglobin (Hb) levels, known as Hb variability, during EPO treatment is a well-documented phenomenon. Malnutrition is a well-known risk factor in the general population and in HD patients. However, few studies have evaluated the association between EPO responsiveness/Hb variability and nutritional status in HD patients. Therefore, our aim was to investigate whether EPO responsiveness and Hb variability can be associated with nutritional status in HD patients undergoing NESP® (darbepoetin-alfa; Kyowa Kirin Korea Co., Ltd.) treatment. Method In this prospective study, we included adult ninety-eight patients aged over 20 years who had been undergoing HD over 6 months. The target hemoglobin (Hb) level is 10–11 g/dL according to the Korean reimbursement guideline. Dose adjustments of NESP® were made according to the Hb level measured monthly in our facility. Every study population have more than 24 monthly Hb data points. We checked average darbepoetin-alfa dose weekly and the EPO resistance index (ERI) as a marker of EPO responsiveness was calculated by dividing the weekly average darbepoetin-alfa dose by the Hb level. In addition, we evaluated the more than 24 month Hb variability, which was expressed by Hb-Coefficient of Variation (Hb-CV). All of them were measured by BCM® (Fresenius Medical Care a Deutschland GmbH, Germany) to assess the nutritional status three times (Baseline, 12 Mos, 24 Mos). Nutritional parameters obtained by BCM® were body mass index (BMI), fat tissue index (FTI), lean tissue index (LTI), body cell mass index, phase angle (PhA). Clinical parameters and routine biochemical tests such as dose of erythropoietin, Kt/Vurea, iron and lipid profiles, C-reactive protein, albumin, calcium, phosphorus, intact-parathyroid hormone were also taken into account. Results In this study, the mean age of the patients was 64.0 ± 11.9 years, and 55.0% were male. Dialysis vintage was 54.9 ± 46.8 months. Follow-up duration was 79.3±47.9 months. Mean Hb was 10.7 ± 1.3 g/dL. We divided into tertiles (T) according to the ERI. The average ERI was 0.02 ± 0.01, 0.04 ± 0.01, and 0.07 ± 0.03 in ERI-T1, ERI-T2, and ERI-T3, respectively. The ERI-T3 group had the lower Hb level (p = 0.038) whereas administration dose of EPO were higher in ERI-T3 (p = 0.001). The ERI-T3 group had the lower PhA (p = 0.044), BMI (p = 0.001) and FTI (p = 0.046) values. We divided into tertiles (T) according to the Hb-CV. The average Hb-CV was 0.06 ± 0.01, 0.08 ± 0.05, and 0.12 ± 0.02 in Hb-CV-T1, Hb-CV-T2, and Hb-CV-T3, respectively. When comparing the three groups, the Hb-CV-T3 group had the lower BMI (p = 0.002) and lower FTI (p = 0.002). Age (r = 0.203, p = 0.036), female sex (r = 0.376, p = 0.001), presence of diabetes mellitus (r = 0.191, p = 0.049), total iron binding capacity (r = 0.205, p = 0.035) and triglyceride (r = 0.227, p = 0.018) were positively correlated with FTI. ERI (r = -0.193, p = 0.046) and Hb-CV (r = -0.268, p = 0.005) were negatively correlated with FTI. In multiple linear regression analysis, FTI was negatively associated with ERI (β = -0.218, p = 0.014), Hb-CV (β = -0.181, p = 0.039), whereas FTI was positively associated with age (β = 0.197, p = 0.017) and female sex (β = 0.386, p = 0.001). Conclusion In HD patients with higher ERI, PhA, BMI and FTI were significantly decreased. Furthermore, in patients with high Hb-CV, BMI and FTI were decreased. In addition, FTI was negatively associated with ERI and Hb-CV. Therefore, EPO responsiveness and Hb-variability is associated with nutritional status, especially fat tissue in hemodialysis patients undergoing darbepoetin-alfa treatment.

Evaluation of the efficacy of using gnri and mis as a predictor of mortality in elderly hemodialysis patients.

Malnutrition is one of the most common geriatric syndromes in hemodialysis (HD) patients. Although there is no gold standard for evaluating nutritional status in HD patients, the Subjective Global Assessment (SGA), Geriatric Nutritional Risk Index (GNRI), and Malnutrition-Inflammation Score (MIS) are widely used in clinical settings. To examine the efficacy of using Geriatric Nutritional Risk Index (GNRI) and Malnutrition-Inflammation Score (MIS) as a predictor of mortality in elderly hemodialysis patients. A retrospective cohort study was carried out in Malatya Training and Research Hospital's Hemodialysis Unit between July 2018 and August 2022. Two hundred seventy-four elderly hemodialysis patients were included in the study. Demographic characteristics, laboratory parameters, and anthropometric measurements of the patients were reviewed. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 16.0 software (SPSS Inc., Chicago, IL, USA). Logistic regression analysis was performed to identify independent predictors of mortality. The mean age of 83 patients who died was 70.00 ± 8.39 years and 47 (56.6%) of these patients were male. All-cause death occurred in 69 (71.1%) of 97 patients with an MIS of ≥6. All-cause death occurred in 24 (54.5%) of 44 patients with a GNRI score of <91.2. Accordingly, MIS (P < 0.001, OR = 1.376 [0.163-0.392]), GNRI (P = 0.001, OR = -0.431 [1.189-1.990]), and age (P = 0.021, OR = 0.109 [0.818-0.984]) were found to be independent predictors of all-cause mortality. GNRI and MIS are important predictors of increased risk of mortality from all causes in elderly HD patients.

NUTRITIONAL STATUS PROFILE OF CKD PATIENTS THAT ARE REGULARLY HEMODIALYSIS IN UNIVERSITAS AIRLANGGA HOSPITAL

CKD patients, especially those undergoing hemodialysis, often have poor nutritional status. This condition can increase morbidity and mortality and decrease the patients quality of life, therefore an assessment of nutritional status in hemodialysis patients is important. This study aims to determine the nutritional status of CKD patients undergoing hemodialysis at the Universitas Airlangga Hospital. This research is a quantitative research using a descriptive method. The sample was taken by total sampling technique and obtained from a sample of 50 people who are regular hemodialysis patients at the Universitas Airlangga Hospital. The nutritional status of patients was assessed based on Body Mass Index (BMI), serum albumin levels, body fat percentage and skeletal muscle percentage. The data obtained were analyzed descriptively and presented in the form of a table containing the percentage, mean, and standard deviation. The results showed the characteristics of the subjects such as gender, age, BMI, serum albumin levels, body fat percentage, and skeletal muscle percentage. From the results of this study, it was found that the characteristics of the research subjects were the same between the sexes of male (50%) and female (50%) with the highest age group between 50-59 years (36%). The largest proportion of subjects had a normal BMI (56%), 36% of subjects had hypoalbuminemia, the majority of body fat percentages were high (34%) and the majority of subjects had low muscle mass (52%).

Nutritional Status of Hemodialysis Patients with End Stage Renal Disease and Selection and Application of Oral Nutritional Support

Nutritional Status of Hemodialysis Patients with End Stage Renal Disease and Selection and Application of Oral Nutritional Support

The relationship between nutrition screenings and nutritional status determined by malnutrition in hemodialysis patients

Objective: It is aimed to evaluate the relationship of food consumptions, biochemical blood parameters, and some anthropometrics with the screening tests using in the nutritional status of hemodialysis patients with end stage renal failure. Materials and Methods: The survey were conducted with 110 hemodialysis patients who hospitalized at the Nephrology Clinic in Akdeniz University Hospital. The routine biochemical blood parameters of the patients were analyzed and their anthropometric measurements were performed. The food consumptions were recorded by the dietician and Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)has screening tests using were performed. Results: The average age of the patients participating in the study was 55 ± 19 years. In MUST, 42.7% of the patients were at high risk, 18.2% of them at moderate risk by malnutrition. Statistically significant relationship was also negatively determined between body weight, dry weight, BMI, the waist circumference, and MUST and SGA (p&lt;0.05). A negatively significant relationship was statistically found among albumin, creatinine, hemoglobin and calcium readouts by NRS2002, among albumin, BUN, calcium and phosphorus readouts by MUST, among albumin, hemoglobin and calcium readouts by SGA (p&lt;0.05). Conclusion: It was observed that the dialysis patients could not get the advised nutritional quantities, thence malnutrition progressed. It is concluded that anthropometric measurements are more concordant with MUST and the biochemical symptoms with NRS2002, and therefore both must be taken into consideration in the assessment of nutritional status correctly of the end-stage renal patients undergoing hemodialysis.

Oral energy supplementation improves nutritional status in hemodialysis patients with protein-energy wasting: A pilot study.

Background: Protein-energy wasting (PEW) is highly prevalent in hemodialysis (HD) patients, which is associated with poor quality of life, complications, and an increased risk of mortality. A prospective study in HD patients with 2months of oral energy supplements (OESs) was performed. Methods: A total of 37 HD patients with PEW were finally enrolled in this prospective study and were randomized into the OES group (n = 19), which received oral energy supplementation (300kcal) and dietary recommendations, while patients in the non-OES group (n = 18) received only dietary recommendations. The study duration was 2months. The nutritional status of the patients was evaluated by laboratory indexes, body composition parameters, and the modified quantitative subjective global assessment (MQSGA) and malnutrition-inflammation score (MIS). Quality of life was evaluated by the Short Form Health Survey Questionnaire (SF-36). Results: After 2months of therapy, a significant increase in serum albumin [39.6 (37.6-45.8) vs. 43.4 (39.1-46.7) g/L; p = 0.018], hemoglobin (101.0 ± 13.6g/L vs. 111.8 ± 11.7g/L; p = 0.042), and dietary energy intake (29.17 ± 3.22kcal/kg/day vs. 33.60 ± 2.72kcal/kg/day, p < 0.001) was observed in the comparisons of baseline in the OES group. Moreover, the OES group demonstrated significant amelioration in MQSGA [9 (8-13) vs. 8 (7-12), p < 0.001] and MIS [5 (3-10) vs. 3 (2-8), p < 0.001], physical functioning (p < 0.001), and mental health (p = 0.046) subsections of SF-36 compared with the baseline. No electrolyte disorders or dyslipidemia were observed in the OES group. Conclusion: OES in HD patients with PEW can significantly ameliorate energy supply, nutritional status, anemia, and quality of life.