Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh
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 setti...
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my.upm.eprints.1029332024-06-23T00:43:16Z http://psasir.upm.edu.my/id/eprint/102933/ Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh Rahman, Tanjina Khor, Ban-Hock Sahathevan, Sharmela Kaur, Deepinder Latifi, Eno Afroz, Mousume Mitali, Esrat Jahan Tashkandi, Bayan Begum, Nura Afza Salma Kashem, Tasnuva Sarah Arefin, Shakib Uz Zaman Daud, Zulfitri Azuan Mat Karupaiah, Tilakavati Rashid, Harun Ur Khosla, Pramod 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. MDPI 2022 Article PeerReviewed Rahman, Tanjina and Khor, Ban-Hock and Sahathevan, Sharmela and Kaur, Deepinder and Latifi, Eno and Afroz, Mousume and Mitali, Esrat Jahan and Tashkandi, Bayan and Begum, Nura Afza Salma and Kashem, Tasnuva Sarah and Arefin, Shakib Uz Zaman and Daud, Zulfitri Azuan Mat and Karupaiah, Tilakavati and Rashid, Harun Ur and Khosla, Pramod (2022) Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh. Nutrients, 14 (7). art. no. 1469. pp. 1-13. ISSN 2072-6643 https://www.mdpi.com/2072-6643/14/7/1469 10.3390/nu14071469 |
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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. |
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Article |
author |
Rahman, Tanjina Khor, Ban-Hock Sahathevan, Sharmela Kaur, Deepinder Latifi, Eno Afroz, Mousume Mitali, Esrat Jahan Tashkandi, Bayan Begum, Nura Afza Salma Kashem, Tasnuva Sarah Arefin, Shakib Uz Zaman Daud, Zulfitri Azuan Mat Karupaiah, Tilakavati Rashid, Harun Ur Khosla, Pramod |
spellingShingle |
Rahman, Tanjina Khor, Ban-Hock Sahathevan, Sharmela Kaur, Deepinder Latifi, Eno Afroz, Mousume Mitali, Esrat Jahan Tashkandi, Bayan Begum, Nura Afza Salma Kashem, Tasnuva Sarah Arefin, Shakib Uz Zaman Daud, Zulfitri Azuan Mat Karupaiah, Tilakavati Rashid, Harun Ur Khosla, Pramod Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
author_facet |
Rahman, Tanjina Khor, Ban-Hock Sahathevan, Sharmela Kaur, Deepinder Latifi, Eno Afroz, Mousume Mitali, Esrat Jahan Tashkandi, Bayan Begum, Nura Afza Salma Kashem, Tasnuva Sarah Arefin, Shakib Uz Zaman Daud, Zulfitri Azuan Mat Karupaiah, Tilakavati Rashid, Harun Ur Khosla, Pramod |
author_sort |
Rahman, Tanjina |
title |
Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
title_short |
Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
title_full |
Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
title_fullStr |
Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
title_full_unstemmed |
Protein energy wasting in a cohort of maintenance hemodialysis patients in Dhaka, Bangladesh |
title_sort |
protein energy wasting in a cohort of maintenance hemodialysis patients in dhaka, bangladesh |
publisher |
MDPI |
publishDate |
2022 |
url |
http://psasir.upm.edu.my/id/eprint/102933/ https://www.mdpi.com/2072-6643/14/7/1469 |
_version_ |
1802978825478340608 |
score |
13.18916 |