ArticleClinical journal of the American Society of Nephrology : CJASN2015
Nutritional Competence and Resilience among Hemodialysis Patients in the Setting of Dialysis Initiation and Hospitalization.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 29 citations in OpenAlex.
- The Effect of Muscle Cramps During Hemodialysis on Quality of Life and Habitual Physical Activity.Medicina (Kaunas, Lithuania) · 2024Article
- Short-term and long-term survival in patients with prevalent haemodialysis-an integrated prognostic model: external validation.BMJ supportive & palliative care · 2024Article
- Biphasic Dynamics of Inflammatory Markers Following Hemodialysis Initiation: Results From the International MONitoring Dialysis Outcome Initiative.Kidney international reports · 2023Article
- Trajectories of Nutritional Parameters Before and After Prescribed Oral Nutritional Supplements: A Longitudinal Cohort Study of Patients With Chronic Kidney Disease Not Requiring Dialysis.Canadian journal of kidney health and disease · 2022Article
- Estimation of Muscle Mass in the Integrated Assessment of Patients on Hemodialysis.Frontiers in nutrition · 2021Review
- Relationship between serum phosphate levels and survival in chronic hemodialysis patients: interactions with age, malnutrition and inflammation.Clinical kidney journal · 2021Article
- Cycles, Arrows and Turbulence: Time Patterns in Renal Disease, a Path from Epidemiology to Personalized Medicine?Blood purification · 2019Review
- Discharge service as a determinant of 30-day readmission in a cohort of maintenance hemodialysis patients: a retrospective cohort study.BMC nephrology · 2017Article
- Changes in urine volume and serum albumin in incident hemodialysis patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2017Article
- Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease.Jornal brasileiro de nefrologiaArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesDialysis patients have a high risk for inadequate nutrition. Their nutritional status is particularly susceptible to deterioration when faced with intercurrent events such as hospitalization. This study was conducted to improve the understanding of the temporal evolution of nutritional parameters as a foundation for rational and proactive nutritional intervention. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective cohort study was performed to investigate the temporal evolution of nutritional parameters (serum albumin, serum phosphate, serum creatinine, equilibrated normalized protein catabolic rate, and interdialytic weight gain) and a composite nutritional score derived from these parameters, in two populations: (1) incident hemodialysis (HD) patients who started HD between January 2006 and December 2011 and were followed for up to 54 months (median 16.3), and (2) prevalent patients with HD vintage ≥2.5 years who were hospitalized between January 2006 and December 2011 and followed from 6 months before to 6 months after hospitalization.
resultsIn incident patients (n=126,964), each of the nutritional parameters improved after HD initiation, with a mean composite nutritional score at the 24th percentile at the start of HD and reaching a plateau at the 57th percentile toward the end of the second year on dialysis. Nutritional parameters increased more rapidly and reached higher values among patients who survived longer. In hospitalized patients (n=14,193), the nutritional parameters and the composite score began to decline 1-2 months before hospitalization, reached their lowest level in the month after hospitalization, and then partially recovered in the subsequent 5 months. The degree of recovery of the nutritional score was inversely related to the number of rehospitalizations.
conclusionsThis study increases the understanding of nutritional resilience and its determinants in HD patients. Application of the nutritional score, pending further validation, may facilitate targeted and timely interventions to avert the negative consequences of inadequate nutrition in chronic HD patients.
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