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Prevalence of protein-energy wasting (PEW) and evaluation of diagnostic criteria in Japanese maintenance hemodialysis patients.
Asia Pac J Clin Nutr 2016; 25(2):292-9AP

Abstract

BACKGROUND AND OBJECTIVES

The International Society of Renal Nutrition and Metabolism (ISRNM) has recently recommended the use of the term "protein-energy wasting" (PEW). PEW is a state of malnutrition with decreased body stores of protein and energy fuel in hemodialysis patients and is known as a risk factor for morbidity and mortality. We examined the prevalence of PEW and the characteristics of PEW patients in a hemodialysis center in Japan.

METHODS AND STUDY DESIGN

Fifty-nine outpatients undergoing maintenance hemodialysis at Iga City General Hospital were evaluated. We observed their biochemical data, body composition, dietary intake, and the number of steps prospectively. PEW was defined according to ISRNM criteria.

RESULTS

Nine patients (15% of total) were diagnosed as having PEW. Among indicators of PEW criteria, the relevance ratios of "reduced muscle mass" and "unintentional low dietary energy intake" were significantly higher in PEW than in non-PEW. The number of steps was lower, and serum levels of glucose and C-reactive protein were higher in PEW.

CONCLUSION

About 15% of Japanese hemodialysis patients are estimated to have PEW. Our results suggested that major contributing factors to PEW were reduced muscle mass, unintentional low dietary energy intake, lower amount of exercise, insulin resistance, and chronic inflammation.

Authors+Show Affiliations

Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.Department of Nutrition, Iga City General Hospital, Iga-City, Mie, Japan.Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.Dialysis Center, Iga City General Hospital, Iga-City, Mie, Japan.Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu-City, Mie, Japan.Department of Surgery, Iga City General Hospital, Iga-City, Mie, Japan.Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Email: hamada@tokushima-u.ac.jp. Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27222412

Citation

Yasui, Sonoko, et al. "Prevalence of Protein-energy Wasting (PEW) and Evaluation of Diagnostic Criteria in Japanese Maintenance Hemodialysis Patients." Asia Pacific Journal of Clinical Nutrition, vol. 25, no. 2, 2016, pp. 292-9.
Yasui S, Shirai Y, Tanimura M, et al. Prevalence of protein-energy wasting (PEW) and evaluation of diagnostic criteria in Japanese maintenance hemodialysis patients. Asia Pac J Clin Nutr. 2016;25(2):292-9.
Yasui, S., Shirai, Y., Tanimura, M., Matsuura, S., Saito, Y., Miyata, K., ... Hamada, Y. (2016). Prevalence of protein-energy wasting (PEW) and evaluation of diagnostic criteria in Japanese maintenance hemodialysis patients. Asia Pacific Journal of Clinical Nutrition, 25(2), pp. 292-9. doi:10.6133/apjcn.2016.25.2.10.
Yasui S, et al. Prevalence of Protein-energy Wasting (PEW) and Evaluation of Diagnostic Criteria in Japanese Maintenance Hemodialysis Patients. Asia Pac J Clin Nutr. 2016;25(2):292-9. PubMed PMID: 27222412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of protein-energy wasting (PEW) and evaluation of diagnostic criteria in Japanese maintenance hemodialysis patients. AU - Yasui,Sonoko, AU - Shirai,Yumiko, AU - Tanimura,Mayu, AU - Matsuura,Sayaka, AU - Saito,Yu, AU - Miyata,Kazuaki, AU - Ishikawa,Eiji, AU - Miki,Chikao, AU - Hamada,Yasuhiro, PY - 2016/5/26/entrez PY - 2016/5/26/pubmed PY - 2016/7/20/medline SP - 292 EP - 9 JF - Asia Pacific journal of clinical nutrition JO - Asia Pac J Clin Nutr VL - 25 IS - 2 N2 - BACKGROUND AND OBJECTIVES: The International Society of Renal Nutrition and Metabolism (ISRNM) has recently recommended the use of the term "protein-energy wasting" (PEW). PEW is a state of malnutrition with decreased body stores of protein and energy fuel in hemodialysis patients and is known as a risk factor for morbidity and mortality. We examined the prevalence of PEW and the characteristics of PEW patients in a hemodialysis center in Japan. METHODS AND STUDY DESIGN: Fifty-nine outpatients undergoing maintenance hemodialysis at Iga City General Hospital were evaluated. We observed their biochemical data, body composition, dietary intake, and the number of steps prospectively. PEW was defined according to ISRNM criteria. RESULTS: Nine patients (15% of total) were diagnosed as having PEW. Among indicators of PEW criteria, the relevance ratios of "reduced muscle mass" and "unintentional low dietary energy intake" were significantly higher in PEW than in non-PEW. The number of steps was lower, and serum levels of glucose and C-reactive protein were higher in PEW. CONCLUSION: About 15% of Japanese hemodialysis patients are estimated to have PEW. Our results suggested that major contributing factors to PEW were reduced muscle mass, unintentional low dietary energy intake, lower amount of exercise, insulin resistance, and chronic inflammation. SN - 0964-7058 UR - https://www.unboundmedicine.com/medline/citation/27222412/Prevalence_of_protein_energy_wasting__PEW__and_evaluation_of_diagnostic_criteria_in_Japanese_maintenance_hemodialysis_patients_ L2 - http://apjcn.nhri.org.tw/server/APJCN/25/2/292.pdf DB - PRIME DP - Unbound Medicine ER -