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Nutrition in dialysis patients.
J Indian Med Assoc. 2001 Apr; 99(4):206-8, 210-1, 213.JI

Abstract

Adequate nutrition is very important for dialysis patients for a better overall outcome. Protein energy malnutrition is highly prevalent (25-50%) among dialysis patients and is associated with increased morbidity and mortality. Causes of malnutrition in dialysis patients include anorexia (inadequate calorie or protein intake), metabolic acidosis (stimulation of amino acid and protein degradation), and infection/inflammation (stimulation of protein degradation). Anorexia resulting into decreased intake is probably the most important factor. Nutritional assessment can be done by anthropometric measurements, laboratory parameters, subjective global assessment, dialysis malnutrition score, near infra-red interactance and other methods. Subjective global assessment is currently the most accepted one and classifies patients into three nutritional categories: Well nourished, moderately malnourished, and severely malnourished. Prevention of malnutrition by proper dietary counselling and adequate dietary intake starting from redialysis days is probably the most effective therapeutic approach. Other therapeutic approaches include adequate dialysis delivery, avoidance of acidaemia, aggressive treatment of catabolic illnesses and food supplements: Oral, enteral or parenteral, particulary intradialytic parenteral nutrition. Experimental approaches for treatment of malnutrition in dialysis patients include amino acids in peritoneal or haemodialysate, appetite stimulants and use of recombinant human growth hormone and insulin like growth factor I. There are few randomised controlled trials unequivocally proving the efficacy of any treatment modality. Large scale, randomised trials are urgently needed to establish effective therapy for malnutrition in dialysis patients. This applies more so for Indian patients.

Authors+Show Affiliations

Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11666026

Citation

Sharma, R K., and K M. Sahu. "Nutrition in Dialysis Patients." Journal of the Indian Medical Association, vol. 99, no. 4, 2001, pp. 206-8, 210-1, 213.
Sharma RK, Sahu KM. Nutrition in dialysis patients. J Indian Med Assoc. 2001;99(4):206-8, 210-1, 213.
Sharma, R. K., & Sahu, K. M. (2001). Nutrition in dialysis patients. Journal of the Indian Medical Association, 99(4), 206-8, 210-1, 213.
Sharma RK, Sahu KM. Nutrition in Dialysis Patients. J Indian Med Assoc. 2001;99(4):206-8, 210-1, 213. PubMed PMID: 11666026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition in dialysis patients. AU - Sharma,R K, AU - Sahu,K M, PY - 2001/10/23/pubmed PY - 2002/1/5/medline PY - 2001/10/23/entrez SP - 206-8, 210-1, 213 JF - Journal of the Indian Medical Association JO - J Indian Med Assoc VL - 99 IS - 4 N2 - Adequate nutrition is very important for dialysis patients for a better overall outcome. Protein energy malnutrition is highly prevalent (25-50%) among dialysis patients and is associated with increased morbidity and mortality. Causes of malnutrition in dialysis patients include anorexia (inadequate calorie or protein intake), metabolic acidosis (stimulation of amino acid and protein degradation), and infection/inflammation (stimulation of protein degradation). Anorexia resulting into decreased intake is probably the most important factor. Nutritional assessment can be done by anthropometric measurements, laboratory parameters, subjective global assessment, dialysis malnutrition score, near infra-red interactance and other methods. Subjective global assessment is currently the most accepted one and classifies patients into three nutritional categories: Well nourished, moderately malnourished, and severely malnourished. Prevention of malnutrition by proper dietary counselling and adequate dietary intake starting from redialysis days is probably the most effective therapeutic approach. Other therapeutic approaches include adequate dialysis delivery, avoidance of acidaemia, aggressive treatment of catabolic illnesses and food supplements: Oral, enteral or parenteral, particulary intradialytic parenteral nutrition. Experimental approaches for treatment of malnutrition in dialysis patients include amino acids in peritoneal or haemodialysate, appetite stimulants and use of recombinant human growth hormone and insulin like growth factor I. There are few randomised controlled trials unequivocally proving the efficacy of any treatment modality. Large scale, randomised trials are urgently needed to establish effective therapy for malnutrition in dialysis patients. This applies more so for Indian patients. SN - 0019-5847 UR - https://www.unboundmedicine.com/medline/citation/11666026/Nutrition_in_dialysis_patients_ L2 - https://medlineplus.gov/dialysis.html DB - PRIME DP - Unbound Medicine ER -