1
|
Martins C, Saeki SL, do Nascimento MM, Lucas FM, Vavruk AM, Meireles CL, Justino S, Mafra D, Rabito EI, Schieferdecker MEM, Campos LF, van Aanholt DPJ, Hordonho AA, Fidelix MSP. Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease. J Bras Nefrol 2021; 43:236-253. [PMID: 33836040 PMCID: PMC8257272 DOI: 10.1590/2175-8239-jbn-2020-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/07/2020] [Indexed: 11/22/2022] Open
Abstract
This nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions were developed concerning patient screening, care, and nutrition outcome management. The recommendations set out in this document were developed based on international guidelines and papers published in electronic databases such as PubMed, EMBASE(tm), CINHAL, Web of Science, and Cochrane. From a list of internationally standardized terms, twenty nutritionists selected the ones they deemed relevant in clinical practice involving outpatients with CKD. The content validity index (CVI) was calculated with 80% agreement in the answers. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess the strength of evidence and recommendations. A total of 107 terms related to Nutrition Assessment and Reassessment, 28 to Diagnosis, nine to Intervention, and 94 to Monitoring and Evaluation were selected. The list of selected terms and identified tools will be used in the development of training programs and the implementation of standardized nutrition terminology for nutritionists working with patients with chronic kidney disease in Brazil.
Collapse
Affiliation(s)
- Cristina Martins
- Associação Brasileira de Nutrição, Curitiba, PR, Brasil
- Sociedade Brasileira de Nefrologia, Comitê de Nutrição, Curitiba,
PR, Brasil
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- Grupo de Trabalho Internacional da NCPT, Subcomitê Internacional da
Academy of Nutrition and Dietetics (Academy) para a TPCN, Curitiba, PR,
Brasil
- Instituto Cristina Martins de Educação e Pesquisa em Saúde,
Curitiba, PR, Brasil
| | - Simone L. Saeki
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- Instituto Cristina Martins de Educação e Pesquisa em Saúde,
Curitiba, PR, Brasil
| | - Marcelo Mazza do Nascimento
- Sociedade Brasileira de Nefrologia, Comitê de Nutrição, Curitiba,
PR, Brasil
- Universidade Federal do Paraná, Curitiba, PR, Brasil
| | - Fernando M. Lucas
- Sociedade Brasileira de Nefrologia, Comitê de Nutrição, Curitiba,
PR, Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais/Grupo
Nefroclínicas, Belo Horizonte, MG, Brasil
| | - Ana Maria Vavruk
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- Hospital e Maternidade Municipal de São José dos Pinhais, São José
dos Pinhais, PR, Brasil
| | - Christiane L. Meireles
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- University of Texas Health Science Center, School of Nursing, San
Antonio, USA
| | - Sandra Justino
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- Universidade Federal do Paraná, Complexo do Hospital de Clínicas da
UFPR, Curitiba, PR, Brasil
| | - Denise Mafra
- Sociedade Brasileira de Nefrologia, Comitê de Nutrição, Curitiba,
PR, Brasil
- Universidade Federal Fluminense, Rio de Janeiro, RJ, Brasil
| | - Estela Iraci Rabito
- Consórcio de Pesquisa e Implementação da TPCN no Brasil, Curitiba,
PR, Brasil
- Universidade Federal do Paraná, Curitiba, PR, Brasil
| | | | | | - Denise P. J. van Aanholt
- Sociedade Brasileira de Nutrição Parenteral e Enteral, Curitiba, PR,
Brasil
- Federación Latinoamericana de Terapia Nutricional, Nutrición
Clínica y Metabolismo, Ecuador
| | - Ana Adélia Hordonho
- Associação Brasileira de Nutrição, Curitiba, PR, Brasil
- Sociedade Brasileira de Nefrologia, Comitê de Nutrição, Curitiba,
PR, Brasil
- Universidade Estadual de Ciências da Saúde, Hospital Escola Hélvio
Auto e Hospital Metropolitano de Alagoas, Maceió, AL, Brasil
| | | |
Collapse
|
2
|
Li HL, Li H, Cao YF, Qi Y, Wang WQ, Liu SQ, Yang CD, Yu XY, Xu T, Zhu Y, Chen W, Tao JL, Li XW. Effects of keto acid supplements on Chinese patients receiving maintenance hemodialysis: a prospective, randomized, controlled, single-center clinical study. Chin Med J (Engl) 2020; 133:9-16. [PMID: 31923099 PMCID: PMC7028198 DOI: 10.1097/cm9.0000000000000578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The effects of keto acid (KA) supplements on Chinese patients receiving maintenance hemodialysis (MHD) are unclear. This study aimed to evaluate the effects of KA supplementation on nutritional status, inflammatory markers, and bioelectric impedance analysis (BIA) parameters in a cohort of Chinese patients with MHD without malnutrition. METHODS This was a prospective, randomized, controlled, single-center clinical study conducted in 2011 till 2014. Twenty-nine patients with MHD were randomly assigned to a control (n = 14) or a KA (n = 15) group. The control group maintained a dietary protein intake of 0.9 g/kg/day. The KA group received additional KA supplement (0.1 g/kg/day). BIA was used to determine the lean tissue mass, adipose tissue mass, and body cell mass. The patients' nutritional status, dialysis adequacy, and biochemical parameters were assessed at the ends of the third and sixth months with t test or Wilcoxon rank-sum test. RESULTS The daily total energy intake for both groups was about 28 kcal/kg/day. After 6 months, the Kt/V (where K is the dialyzer clearance of urea, t is the dialysis time, and V is the volume of the distribution of urea) was 1.33 ± 0.25 in KA group, and 1.34 ± 0.25 in the control group. The median triceps skin-fold thickness in KA group was 12.00 and 9.00 mm in the control group. In addition, the median hand-grip strength in KA group was 21.10 and 25.65 kg in the control group. There were no significant differences between the groups with respect to the anthropometry parameters, dialysis adequacy, serum calcium and phosphorus levels, inflammatory markers, and amino-acid profiles, or in relation to the parameters determined by BIA. Both groups achieved dialysis adequacy and maintained nutritional status during the study. CONCLUSIONS In this cohort of Chinese patients with MHD, the patients in the control group whose dietary protein intake was 0.9 g/kg/day and total energy intake was 28 kcal/kg/day, maintained well nutritional status during study period. The KA supplement (0.1 g/kg/day) did not improve the essential amino acid/non-essential amino acid ratio, nor did it change the patients' mineral metabolism, inflammatory parameters, or body compositions.
Collapse
Affiliation(s)
- Hai-Long Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Hui Li
- Department of Nephrology, Shanxi Medical College Affiliated First Hospital, Taiyuan, Shanxi 030001, China
| | - Yi-Fu Cao
- Department of Nephrology, Shijiazhuang Third Hospital, Shijiazhuang, Hebei 050011, China
| | - Yue Qi
- Department of Nephrology, Shanxi Medical College Affiliated Second Hospital, Taiyuan, Shanxi 030001, China
| | - Wei-Qi Wang
- School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Shi-Qin Liu
- Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Chen-Die Yang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiao-Yan Yu
- Department of Nephrology, Qiqihar Medical College Affiliated Third Hospital, Qiqihar, Heilongjiang 161000, China
| | - Tao Xu
- Department of Statistics, Institute of Basic Medical Sciences, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yan Zhu
- Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Wei Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jian-Ling Tao
- Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xue-Wang Li
- Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| |
Collapse
|
3
|
Xu L, Yu L, Chi N, Wang W, Liu G, Shi W. Plasma ghrelin levels in association with left ventricular function and nutritional status in dialysis patients. Biomed Rep 2016; 5:45-49. [PMID: 27347404 PMCID: PMC4907035 DOI: 10.3892/br.2016.666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/15/2016] [Indexed: 12/21/2022] Open
Abstract
The present study investigated the association between ghrelin levels and the cardiac function and malnutrition of dialysis patients. The aim was to examine the conducive use of exogenous ghrelin to improve the malnutrition, protect the cardiovascular function with dialysis patients in the future. The study included 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 30 hemodialysis (HD) patients undertaking treatment between March 2013 and March 2014. The control group included a total of 30 healthy physical examinees. The plasma ghrelin levels were measured by the enzyme-linked immunosorbent assay to collect the clinical materials and biochemical parameters. The plasma ghrelin levels were 4.28±1.07, 4.63±1.08 and 2.00±0.48 ng/ml in the CAPD, HD and control groups, respectively, and statistical significance was identified between the three groups; F=75.106, P<0.0001. The plasma ghrelin levels in the CAPD group were positively correlated with left ventricular ejection fraction (LVEF) (r=0.506, P=0.004) and were negatively correlated with body mass index (BMI) (r=−0.556, P=0.001). The plasma ghrelin levels in the CAPD and HD groups were positively correlated with serum creatinine (Scr) and blood urea nitrogen (BUN). In conclusion, the plasma ghrelin levels of patients in the CAPD and HD groups were higher compared to those of the control group, which demonstrated that dialysis patients could not effectively remove the plasma ghrelin. The present study found that the plasma ghrelin levels were positively correlated with LVEF, and high levels of ghrelin will exhibit protective effects on the cardiovascular function of CAPD patients. Plasma ghrelin levels were positively correlated with Scr and BUN levels in CAPD and HD patients, and were negatively correlated with BMI in CAPD patients, which showed that ghrelin was correlated with malnutrition of dialysis patients.
Collapse
Affiliation(s)
- Libin Xu
- Southern Medical University, Guangzhou, Guangdong 510515, P.R. China; Division of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510515, P.R. China; Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, P.R. China
| | - Lei Yu
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, P.R. China
| | - Ning Chi
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, P.R. China
| | - Wenhao Wang
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, P.R. China
| | - Guoping Liu
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010017, P.R. China
| | - Wei Shi
- Southern Medical University, Guangzhou, Guangdong 510515, P.R. China; Division of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510515, P.R. China
| |
Collapse
|