Nutrition in hemodialysis patients previously on a supplemented very low protein diet

Nutrition in hemodialysis patients previously on a supplemented very low protein diet. Nutritional safety of protein-restricted diets in patients with chronic renal failure is controversial. In the present study, we have assessed the evolution of nutritional status after initiation of hemodialysis i...

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Vydáno v:Kidney international Ročník 63; číslo 4; s. 1491 - 1498
Hlavní autoři: Vendrely, Benoît, Chauveau, Philippe, Barthe, Nicole, El Haggan, Wael, Castaing, Françoise, De Précigout, Valérie, Combe, Christian, Aparicio, Michel
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York, NY Elsevier Inc 01.04.2003
Nature Publishing
Elsevier Limited
Témata:
Absorptiometry, Photon
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
body composition
Body Mass Index
densitometry
diet
Diet, Protein-Restricted
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Kidney Failure, Chronic - diet therapy
Male
Medical sciences
Middle Aged
Nutrition Assessment
nutritional status
Prospective Studies
Protein-Energy Malnutrition - prevention & control
protein-restricted
Renal Dialysis
x-ray
body composition
nutritional status
protein-restricted
x-ray
densitometry
diet
renal dialysis
Kidney disease
Human
Urinary system disease
Deficient diet
Hemodialysis
Protein
Feeding
Extrarenal dialysis
Chronic
Treatment
Renal failure
ISSN:0085-2538, 1523-1755
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Shrnutí:Nutrition in hemodialysis patients previously on a supplemented very low protein diet. Nutritional safety of protein-restricted diets in patients with chronic renal failure is controversial. In the present study, we have assessed the evolution of nutritional status after initiation of hemodialysis in patients previously treated by a supplemented very low protein diet (SVLPD). Nutritional data were prospectively collected during the first year of hemodialysis from 15 consecutive patients treated with a SVLPD (0.3 g protein/kg/day supplemented with essential amino acids, calcium, iron, and vitamins) and compared to 15 age- and gender-matched end-stage renal disease (ESRD) patients previously on a less-restricted diet (0.90 ± 0.21 g protein/kg/day) who started hemodialysis during the same period. Dual-energy x-ray absorptiometry (DEXA) was used to assess body composition at 0, 6, and 12 months. Hemodialysis prescriptions, biologic data and 3-day food records were collected every 3 months. Protein intake was higher than 1.2 g/kg/day in both groups as soon as 3 months after the start of hemodialysis. Albumin and prealbumin increased significantly during the first 6 months in all patients. Body mass index (BMI) increased in all patients (+0.97 ± 1.31 kg/m2; P < 0.001) reflecting a gain in fat mass in the overall population (+2.36 ± 2.94 kg/m2; P < 0.001) while lean body mass remained stable overall. Once on hemodialysis, SVLPD patients rapidly increased protein intake. Nutritional status improved in all patients, with a gain in fat mass in all, and a gain in lean body mass in SVLPD men only. These data indicate that treatment with a SVLPD prior to hemodialysis initiation is nutritionally safe.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0085-2538
1523-1755
DOI:10.1046/j.1523-1755.2003.00884.x