Hemodialysis—Nutritional Flaws in Diagnosis and Prescriptions. Could Amino Acid Losses Be the Sharpest “Sword of Damocles”?
Open Access
- 14 June 2020
- Vol. 12 (6), 1773
- https://doi.org/10.3390/nu12061773
Abstract
This review aims to highlight the strengths and weaknesses emerging from diagnostic evaluations and prescriptions in an intent to prevent progression over time of malnutrition and/or protein-energy wasting (PEW) in hemodialysis (HD) patients. In particular, indications of the most effective pathway to follow in diagnosing a state of malnutrition are provided based on a range of appropriate chemical-clinical, anthropometric and instrumental analyses and monitoring of the nutritional status of HD patients. Finally, based on the findings of recent studies, therapeutic options to be adopted for the purpose of preventing or slowing down malnutrition have been reviewed, with particular focus on protein-calorie intake, the role of oral and/or intravenous supplements and efficacy of some classes of amino acids. A new determining factor that may lead inexorably to PEW in hemodialysis patients is represented by severe amino acid loss during hemodialysis sessions, for which mandatory compensation should be introduced.This publication has 143 references indexed in Scilit:
- Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease: A Consensus Statement From the International Society of Renal Nutrition and Metabolism (ISRNM)Journal of Renal Nutrition, 2013
- Comment intégrer les patients dans l’élaboration de programmes d’éducation thérapeutique dans l’insuffisance rénale chronique ?Nephrologie & Therapeutique, 2013
- Effects of oral amino acid supplementation on long-term-care-acquired infections in elderly patientsArchives of Gerontology and Geriatrics, 2011
- Quality-of-Life and Mortality in Hemodialysis PatientsClinical Journal of the American Society of Nephrology, 2011
- Association of Serum Total Iron-Binding Capacity and Its Changes Over Time with Nutritional and Clinical Outcomes in Hemodialysis PatientsAmerican Journal of Nephrology, 2009
- A proposed nomenclature and diagnostic criteria for protein–energy wasting in acute and chronic kidney diseaseKidney International, 2008
- A Geospatial Analysis of Emergency Transport and Inter-Hospital Transfer in ST-Segment Elevation Myocardial InfarctionThe American Journal of Cardiology, 2008
- Reliability of Mini Nutritional Assessment in Hemodialysis Compared With Subjective Global AssessmentJournal of Renal Nutrition, 2006
- Effect of different membranes on amino-acid losses during haemodialysisNephrology Dialysis Transplantation, 1998
- Postdialysis urea rebound: Determinants and influence on dialysis delivery in chronic hemodialysis patientsAmerican Journal of Kidney Diseases, 1996