Cargando…

Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh

Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000–40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setti...

Descripción completa

Detalles Bibliográficos
Autores principales: Rahman, Tanjina, Khor, Ban-Hock, Sahathevan, Sharmela, Kaur, Deepinder, Latifi, Eno, Afroz, Mousume, Mitali, Esrat Jahan, Tashkandi, Bayan, Begum, Nura Afza Salma, Kashem, Tasnuva Sarah, Arefin, Shakib Uz Zaman, Daud, Zulfitri Azuan Mat, Karupaiah, Tilakavati, Rashid, Harun Ur, Khosla, Pramod
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9002623/
https://www.ncbi.nlm.nih.gov/pubmed/35406082
http://dx.doi.org/10.3390/nu14071469
_version_ 1784685935843082240
author Rahman, Tanjina
Khor, Ban-Hock
Sahathevan, Sharmela
Kaur, Deepinder
Latifi, Eno
Afroz, Mousume
Mitali, Esrat Jahan
Tashkandi, Bayan
Begum, Nura Afza Salma
Kashem, Tasnuva Sarah
Arefin, Shakib Uz Zaman
Daud, Zulfitri Azuan Mat
Karupaiah, Tilakavati
Rashid, Harun Ur
Khosla, Pramod
author_facet Rahman, Tanjina
Khor, Ban-Hock
Sahathevan, Sharmela
Kaur, Deepinder
Latifi, Eno
Afroz, Mousume
Mitali, Esrat Jahan
Tashkandi, Bayan
Begum, Nura Afza Salma
Kashem, Tasnuva Sarah
Arefin, Shakib Uz Zaman
Daud, Zulfitri Azuan Mat
Karupaiah, Tilakavati
Rashid, Harun Ur
Khosla, Pramod
author_sort Rahman, Tanjina
collection PubMed
description Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000–40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setting in Dhaka. Patients were 49% male, age 50 ± 13 years, 62% were on twice-weekly hemodialysis. Anthropometric, biochemical, and laboratory evaluations revealed: BMI 24.1 ± 5.2 kg/m(2), mid-arm muscle circumference (MAMC) 21.6 ± 3.6 cm, and serum albumin 3.7 ± 0.6 g/dL. Based on published criteria, 18% patients had PEW and for these patients, BMI (19.8 ± 2.4 vs. 25.2 ± 5.2 kg/m(2)), MAMC (19.4 ± 2.4 vs. 22.2 ± 3.8 cm), serum albumin (3.5 ± 0.7 vs. 3.8 ± 0.5 g/dL), and total cholesterol (135 ± 34 vs. 159 ± 40 mg/dL), were significantly lower as compared to non-PEW patients, while hand grip strength was similar (19.5 ± 7.6 vs. 19.7 ± 7.3 kg). Inflammatory C-reactive protein levels tended to be higher in the PEW group (20.0 ± 34.8 vs. 10.0 ± 13.9 p = 0.065). Lipoprotein analyses revealed PEW patients had significantly lower low density lipoprotein cholesterol (71 ± 29 vs. 88 ± 31 mg/dL, p < 0.05) and plasma triglyceride (132 ± 51 vs. 189 ± 103 mg/dL, p < 0.05), while high density lipoprotein cholesterol was similar. Nutritional assessments using a single 24 h recall were possible from 115 of the patients, but only 66 of these were acceptable reporters. Amongst these, while no major differences were noted between PEW and non-PEW patients, the majority of patients did not meet dietary recommendations for energy, protein, fiber, and several micronutrients (in some cases intakes were 60–90% below recommendations). Malnutrition Inflammation Scores were significantly higher in PEW patients (7.6 ± 3.1 vs. 5.3 ± 2.7 p < 0.004). No discernible differences were apparent in measured parameters between patients on twice- vs. thrice-weekly dialysis. Data from a larger cohort are needed prior to establishing patient-management guidelines for PEW in this population.
format Online
Article
Text
id pubmed-9002623
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-90026232022-04-13 Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh Rahman, Tanjina Khor, Ban-Hock Sahathevan, Sharmela Kaur, Deepinder Latifi, Eno Afroz, Mousume Mitali, Esrat Jahan Tashkandi, Bayan Begum, Nura Afza Salma Kashem, Tasnuva Sarah Arefin, Shakib Uz Zaman Daud, Zulfitri Azuan Mat Karupaiah, Tilakavati Rashid, Harun Ur Khosla, Pramod Nutrients Article Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000–40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setting in Dhaka. Patients were 49% male, age 50 ± 13 years, 62% were on twice-weekly hemodialysis. Anthropometric, biochemical, and laboratory evaluations revealed: BMI 24.1 ± 5.2 kg/m(2), mid-arm muscle circumference (MAMC) 21.6 ± 3.6 cm, and serum albumin 3.7 ± 0.6 g/dL. Based on published criteria, 18% patients had PEW and for these patients, BMI (19.8 ± 2.4 vs. 25.2 ± 5.2 kg/m(2)), MAMC (19.4 ± 2.4 vs. 22.2 ± 3.8 cm), serum albumin (3.5 ± 0.7 vs. 3.8 ± 0.5 g/dL), and total cholesterol (135 ± 34 vs. 159 ± 40 mg/dL), were significantly lower as compared to non-PEW patients, while hand grip strength was similar (19.5 ± 7.6 vs. 19.7 ± 7.3 kg). Inflammatory C-reactive protein levels tended to be higher in the PEW group (20.0 ± 34.8 vs. 10.0 ± 13.9 p = 0.065). Lipoprotein analyses revealed PEW patients had significantly lower low density lipoprotein cholesterol (71 ± 29 vs. 88 ± 31 mg/dL, p < 0.05) and plasma triglyceride (132 ± 51 vs. 189 ± 103 mg/dL, p < 0.05), while high density lipoprotein cholesterol was similar. Nutritional assessments using a single 24 h recall were possible from 115 of the patients, but only 66 of these were acceptable reporters. Amongst these, while no major differences were noted between PEW and non-PEW patients, the majority of patients did not meet dietary recommendations for energy, protein, fiber, and several micronutrients (in some cases intakes were 60–90% below recommendations). Malnutrition Inflammation Scores were significantly higher in PEW patients (7.6 ± 3.1 vs. 5.3 ± 2.7 p < 0.004). No discernible differences were apparent in measured parameters between patients on twice- vs. thrice-weekly dialysis. Data from a larger cohort are needed prior to establishing patient-management guidelines for PEW in this population. MDPI 2022-04-01 /pmc/articles/PMC9002623/ /pubmed/35406082 http://dx.doi.org/10.3390/nu14071469 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rahman, Tanjina
Khor, Ban-Hock
Sahathevan, Sharmela
Kaur, Deepinder
Latifi, Eno
Afroz, Mousume
Mitali, Esrat Jahan
Tashkandi, Bayan
Begum, Nura Afza Salma
Kashem, Tasnuva Sarah
Arefin, Shakib Uz Zaman
Daud, Zulfitri Azuan Mat
Karupaiah, Tilakavati
Rashid, Harun Ur
Khosla, Pramod
Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title_full Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title_fullStr Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title_full_unstemmed Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title_short Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh
title_sort protein energy wasting in a cohort of maintenance hemodialysis patients in dhaka, bangladesh
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9002623/
https://www.ncbi.nlm.nih.gov/pubmed/35406082
http://dx.doi.org/10.3390/nu14071469
work_keys_str_mv AT rahmantanjina proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT khorbanhock proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT sahathevansharmela proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT kaurdeepinder proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT latifieno proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT afrozmousume proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT mitaliesratjahan proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT tashkandibayan proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT begumnuraafzasalma proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT kashemtasnuvasarah proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT arefinshakibuzzaman proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT daudzulfitriazuanmat proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT karupaiahtilakavati proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT rashidharunur proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh
AT khoslapramod proteinenergywastinginacohortofmaintenancehemodialysispatientsindhakabangladesh