Adaptation and Validation of Alternative Healthy Eating Index in Hemodialysis Patients (AHEI-HD) and Its Association with all-Cause Mortality: A Multi-Center Follow-Up Study (original) (raw)
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Nutrients
Background: Hemodialysis patients are at high risk of muscle loss as a result of aging and disease, and combined with inadequate dietary intake. The Healthy Eating Index for HemoDialysis patients (HEI-HD) was developed to assess the dietary quality of hemodialysis patients. The purposes of this study were to examine the effects of different nutritional education models using HEI-HD-based education on dietary quality and muscle mass in hemodialysis patients. Methods: A quasi-experimental study was conducted from May 2019 to April 2021, with four groups, including no course for patients and nurses (Non-C), course for nurses (CN), course for patients (CP), and course for patients and nurses (CPN). The courses were delivered by registered dietitians. The data of 94 patients were collected and analyzed at baseline, after 2 months of intervention, and 2 months follow-up, including demographics, body composition, 3-day dietary records, and hemodialysis dietary knowledge. The HEI-HD index s...
GSC Advanced Research and Reviews, 2020
Assessing dietary habits and nutritional status in patients with end stage kidney disease (ESKD) treated with maintenance hemodialysis (HD) plays a crucial role in the prevention of protein energy malnutrition. The aim of this study was, on one hand, to assess nutritional status and dietary intake of HD patients in comparison with the guidelines recommendations and, on the other hand, to determine the characteristics of those who didn't meet their nutritional needs. In a sample of 156 HD patients (70 women and 86 men), clinical data, anthropometric measurements and two 24 hour dietary recalls were collected to evaluate the nutritional status and dietary intake. The results showed that based on the Body Mass Index (BMI), appropriate nutritional status was reported for only 60.6% of the patients. The mean energy intake was 1904.98 ±592.50 kcal per day, only 16.8% of participants were found compliant regarding the recommended intake of energy density; about 33 % met the recommended minimum of 1.2g/kg of protein per day and only 36.5% have adequate fiber consumption. The protein and energy density were negatively correlated with age, BMI and waist circumference. No patients achieved the recommendations concerning the saturated fat intake. In conclusion, the study data report that a high proportion of dialysis patients did not meet current renal specific dietary requirements and that the diet quality is considered poor. These results call the attention to individual dietetic counseling and promotion of a global dietary approach in hemodialysis patients in order to improve clinical outcomes and the quality of life of chronic kidney patients.
Dietary Quality and Adherence to Dietary Recommendations in Patients Undergoing Hemodialysis
Journal of Renal Nutrition, 2016
Background: The multiple dietary restrictions recommended to hemodialysis patients may be difficult to achieve and, at the same time, may result in nutritional deficiencies rendering a poor dietary quality. We here assess the dietary quality and adherence to renal-specific guideline recommendations among hemodialysis patients from a single center in Canary Islands, Spain. Methods: Cross-sectional study, including 91 patients undergoing maintenance hemodialysis. Clinical data and 3-day dietary records were collected. We compared patient's reported nutrients intake with guideline recommendations. We also evaluated their alignment with current American Heart Association dietary guidelines for cardiovascular prevention. Results: Seventy-seven percent and 50% of patients consumed less than the recommended daily energy and protein, respectively. Although half of the patients met the recommendations for dietary fat intake, this was accounted by an excess of saturated fat in 92% of them. Only 22% consumed sufficient fiber. A very small proportion of patients (less than 50%) met the requirements for vitamins and other micronutrients. Insufficient dietary intake was observed in most patients for all vitamins except for cobalamin. Similarly, inadequate dietary intake was observed for many minerals, by both excess (phosphorus, calcium, sodium, and potassium) and defect (magnesium). Most patients met the recommendations for iron and zinc in their diets. Conclusions: A large proportion of hemodialysis patients at our center did not meet current renal-specific dietary recommendations. The quality of the diet was considered poor and proatherogenic according to American Heart Association guidelines.
Life
Elevated body mass index (BMI) has been associated with improved survival and fewer hospitalizations in hemodialysis patients; however, it is not clear that dietary intake is associated with increased BMI in hemodialysis patients. The present analysis was designed to compare energy and macronutrient intake and distribution, as well as compliance with the International Society of Renal Nutrition and Metabolism (ISRNM) dietary guidelines, by body weight status (overweight/obese vs. normal weight) in hemodialysis patients. The status of nutrition in hemodialysis patients survey (SNIPS) cohort is a cross-sectional study including a representative sample of individuals on hemodialysis treated in hospital dialysis centers throughout Israel. Of the 375 patients eligible for the current analysis, 60.1% had BMI ≥ 25 kg/m2 (overweight/obese). For each participant, the following measures were recorded: dietary intake, blood biochemistry, anthropometric and hemodynamic measures. These were comp...
Dietary intake in adults on hemodialysis compared with guideline recommendations
Journal of Nephrology
Background Clinical practice guidelines of dietary management are designed to promote a balanced diet and maintain health in patients undergoing haemodialysis but they may not reflect patients’ preferences. We aimed to investigate the consistency between the dietary intake of patients on maintenance haemodialysis and guideline recommendations. Methods Cross-sectional analysis of the DIET-HD study, which included 6,906 adults undergoing haemodialysis in 10 European countries. Dietary intake was determined using the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire (FFQ), and compared with the European Best Practice Guidelines. Consistency with guidelines was defined as achieving the minimum daily recommended intake for energy (≥ 30 kcal/kg) and protein (≥ 1.1 g/kg), and not exceeding the maximum recommended daily intake for phosphate (≤ 1000 mg), potassium (≤ 2730 mg), sodium (≤ 2300 mg) and calcium (≤ 800 mg). Results Overall, patients’ dietary intakes...
Variables associated with reduced dietary intake in hemodialysis patients
Journal of Renal Nutrition, 2005
Background: Among the causes of malnutrition in hemodialysis (HD) patients, inadequate dietary intake (IDI) seems to be one of the most frequent and important. Although it has been hypothesized that IDI might be secondary to uremia, anorexia, underlying illness, psychosocial conditions, loss of dentures, depression, aging, or chronic inflammation, definite data on the etiology of IDI in HD patients are still lacking. The goal of this study was to measure the actual dietary energy and protein intakes in stable HD patients and to evaluate which demographic, clinical, dialytic, and humoral variables were associated with a dietary intake lower than recommended by international guidelines.
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2017
To compare the 7-point subjective global assessment (SGA) and the protein energy wasting (PEW) score with nutrition evaluations conducted by registered dietitian nutritionists in identifying PEW risk in stage 5 chronic kidney disease patients on maintenance hemodialysis. This study is a secondary analysis of a cross-sectional study entitled "Development and Validation of a Predictive energy Equation in Hemodialysis". PEW risk identified by the 7-point SGA and the PEW score was compared against the nutrition evaluations conducted by registered dietitian nutritionists through data examination from the original study (reference standard). A total of 133 patients were included for the analysis. The sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (PLR and NLR) of both scoring tools were calculated when compared against the reference standard. The patients were predominately African American (n = 112, 84.2%),...
DIETARY INTAKE AND NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS
Irjp, 2019
This study was conducted on 50 CKD-5 patients during the year 2016-17, considered stable from, 3 months of regular dialysis at least 2 times in a week dialysis centre in MLB, Medical College Jhansi. Dietary intake was estimated by 24-hour recall and analysed after 30 days three times the average dietary intake of 1580.5±164 kcal/day; carbohydrate 204.3±19.0 gm/day; lipid, 49.0±4.6 gm/day, protein 54.0±4.8 gm/day. The significant prevalence was observed for the inadequacy of calories intake and other nutrients. Hemodialysis patients had a lower intake of fruit (77%), vegetable (56%) and dairy products (70%) exchange whereas they had normal intake of oils/fats (95%) and sugars/sweets (97%). This study the reveals that the patient suffered from CKD with dialysis phase were observed loss of appetite and inadequate dietary intake than the recommended, lead to malnutrition, susceptible to various life style diseases and high risk of morbidity.
A Comparison of 8 Nutrition-Related Tests to Predict Mortality in Hemodialysis Patients
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2015
Protein-energy wasting (PEW) describes a state of decreased protein and energy fuels and is highly prevalent in hemodialysis patients. As PEW is associated with mortality, it should be detected accurately and easily. This study investigated which nutrition-related test predicts mortality and morbidity best in hemodialysis patients. Data were used from CONTRAST, a cohort of end-stage kidney disease patients. Subjective Global Assessment (SGA), Malnutrition Inflammation Score (MIS), Geriatric Nutritional Risk Index (GNRI), composite score of Protein-Energy Nutritional Status (cPENS), serum albumin, serum creatinine, body mass index, and normalized protein nitrogen appearance rate were assessed at baseline. End points were all-cause mortality, cardiovascular events, and infection. Discriminative value of every test was assessed with Harrell's C statistic and calibration tested using the Hosmer-Lemeshow goodness-of-fit test. Ultimately, in every test, 4 groups were created to compar...
International Journal of Medical and Health Sciences, 2015
Background: Malnutrition and anorexia are frequent complications in patients on maintenance hemodialysis (MHD) significantly affecting their quality of life, resulting in high morbidity and mortality. A study was conducted to assess the association between anorexia, nutritional status and quality of life. Materials and methods: 90 patients (55 males and 35 females; age range of 25 to 73 years; mean age 52.62 ± 11.7 years) undergoing twice/thrice weekly MHD for six months and above were assessed for self reported appetite using first three questions of Appetite and Diet Assessment tool (ADAT). Anthropometry and Subjective global assessment – Dialysis Malnutrition Scale (SGA-DMS) to were used to assess the nutritional status, and Health survey for dialysis patients Short Form (SF) -36 questionnaire to assess the health related quality of life. Results: Based on SGA-DMS, 54.4 % were moderate to severely malnourished, 31% were mild to moderately malnourished and 14.4% were well nourishe...