Tanjina Rahman and Khor, Ban-Hock and Sharmela Sahathevan and Deepinder Kaur and Eno Latifi and Mousume Afroz and Esrat Jahan and Bayan Tashkandi and Nura Afza Salma Begum and Tasnuva Sarah Kash and Shakib Uz Zaman Arefin and Zulfitri Azuan Mat Daud and Tilakavati Karupaiah and Harun Ur Rashid and Pramod Khosla (2022) Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh. Nutrients, 14. pp. 1-13.
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Abstract
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/m2, 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/m2), 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.
| Item Type: | Article |
|---|---|
| Keyword: | Dyslipidemia, Protein energy wasting, Bangladeshi hemodialysis patients, Nutrition status |
| Subjects: | R Medicine > RC Internal medicine > RC31-1245 Internal medicine T Technology > TX Home economics > TX1-1110 Home economics > TX341-641 Nutrition. Foods and food supply |
| Department: | FACULTY > Faculty of Food Science and Nutrition |
| Depositing User: | SITI AZIZAH BINTI IDRIS - |
| Date Deposited: | 26 Dec 2024 11:13 |
| Last Modified: | 26 Dec 2024 11:13 |
| URI: | https://eprints.ums.edu.my/id/eprint/42386 |
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