Research Article
BibTex RIS Cite

Hemodiyaliz tedavisi alan hastalarda besin alımı ile malnütrisyon inflamasyon skoru arasındaki ilişki

Year 2021, Volume: 46 Issue: 2, 418 - 429, 30.06.2021
https://doi.org/10.17826/cumj.794910

Abstract

Amaç: Bu çalışmanın amacı hemodiyaliz hastalarının besin tüketimlerini inceleyerek, beslenme durumlarının malnütriyon inflamasyon skoru ile ilişkisini değerlendirmektir.
Gereç ve Yöntem: Çalışma 18-65 yaş arası toplam 49 (25 erkek, 24 kadın) hemodiyaliz hastasıyla yapılmıştır. Araştırmacı tarafından hastaların vücut kompozisyonları biyoempedans cihazı ile ölçülmüş, malnutrisyon inflamasyon skoru (MİS) anketi uygulanmış, üç günlük besin tüketimleri alınmıştır.
Bulgular: Yaş ortalamaları 47,6±11,39 yıl olan hastaların ortalama MİS skorları 11,3±4,10 olup %85.7’si malnutrisyonludur. Hastaların; 23.1±10.53 kcal/kg/gün enerji, 0,83±0,39 g/kg/gün protein aldıkları saptanmıştır. Erkek hastaların %80’i, kadın hastaların %83,7’si Uluslararası Böbrek Vakfı’na (NKF) göre yetersiz enerji almaktadır. Erkek hastaların %84’ü, kadın hastaların tamamı NKF’ye göre yetersiz protein almaktadır. Hastaların günlük almış oldukları tiamin, riboflavin, niasin, B6 vitamini, folik asit, C vitamini, çinko, demir, kalsiyum miktarı NKF önerilerinin altındadır. Hastaların BKİ ve vücut kompozisyonları arasında ise negatif yönlü anlamlı bir korelasyon bulunmuştur.
Sonuç: Hastaların günlük enerji, protein ve bazı besin ögesi alımları hemodiyaliz hastaları için önerilen değerlerden oldukça düşük olması ile dikkat çekicidir. Yüksek MİS skoru yetersiz enerji ve besin ögesi alımıyla gelişen malnutrisyonla ilişkili olabilir.

References

  • 1. Akpolat, T., Utaş, C. ve Süleymanlar, G. (2007). Nefroloji el kitabı (4. Baskı). İstanbul: Nobel Tıp Kitabevi.
  • 2. Weekes, C. E., Elia, M. and Emery, P. W. (2004). The development, validation and reliability of a nutrition screening tool based on the recommendations of the British Association for Parenteral and Enteral Nutrition (BAPEN). Clinical Nutrition, 23(5), 1104-1112.
  • 3. Lauılle, M. and Fauque, D. (2000). Nutritional aspects in hemodialysis. Kidney International, 76, 133-139.
  • 4. Heaf, J. (2003). High transport and malnutrition-inflammation-atherosclerosis (MIA) syndrome. Peritoneal Dialysis International, 23(2), 109-110.
  • 5. Mehrotra, R. and Kopple, J. D. (2001). Nutritional management of maintenance dialysis patients: why aren't we doing better? Annual Review of Nutrition, 21(1), 343-379.
  • 6. Kopple, J.D. (1999). Pathophysiology of protein-energy wasting in chronic renal failure. The Journal of Nutrition, 129(1), 247-251.
  • 7. Qureshi, A. R., Alvestrand, A., Danielsson, A., Divino-Filho, J. C., Gutierrez, A., Lindholm, B. and Bergström, J. (1998). Factors predicting malnutrition in hemodialysis patients: a cross-sectional study. Kidney International, 53(3), 773-782.
  • 8. Demir, M. ve Tonbul, H.Z. (2005). Son dönem böbrek yetmezlikli hastalarda malnütrisyoninflamasyon-ateroskleroz (MİA Sendromu). Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 4(14), 160-165.
  • 9. O'Keefe, A. and Daigle, N. W. (2002). A new approach to classifying malnutrition in the hemodialysis patient. Journal of Renal Nutrition, 12(4), 248-255.
  • 10. Stenvinkel, P., Heimbürger, O., Lindholm, B., Kaysen, G. A. and Bergström, J. (2000). Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome). Nephrology Dialysis Transplantation, 15(7), 953-960.
  • 11. Kalantar-Zadeh, K., Block, G., McAllister, C. J., Humphreys, M. H. and Kopple, J. D. (2004). Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. The American Journal of Clinical Nutrition, 80(2), 299-307.
  • 12. Stenvinkel, P., Heimburger, O, Paultre, F. (1999). Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney International, 55, 1899-1911.
  • 13. Yeun, J.Y. and Kaysen, G.A. (1998). Factors influencing serum albumin in dialysis patients. American Journal of Kidney Diseases, 32(6), 118-125.
  • 14. Kaizu, Y., Kimura, M., Yoneyama, T., Miyaji, K., Hibi, I. and Kumagai, H. (1998). Interleukin-6 may mediate malnutrition in chronic hemodialysis patients. American Journal of Kidney Diseases, 31(1), 93-100.
  • 15. Kalantar-Zadeh, K., Ikizler, T. A., Block, G., Avram, M. M. and Kopple, J. D. (2003). Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. American Journal of Kidney Diseases, 42(5), 864-881.
  • 16. Kalantar-Zadeh, K., Block, G., Humphreys, M.H. and Kopple, J.D. (2003). Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney International, 63, 793-808
  • 17. Lowrie, E. G. and Lew, N. L. (1990). Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. American Journal of Kidney Diseases, 15(5), 458-482.
  • 18. Young, G. A., Kopple, J. D., Lindholm, B., Vonesh, E. F., De Vecchi, A., Scalamogna, A., Castelnova, C., Oreopoulos, D. G., Anderson, G. H., Bergstrom, J., DiChiro, J., Gentile, D., Nissenson, A., Sakhrani, L., Brownjohn, A. M., Nolph, K. D., Prowant, B. F., Algrim, C. E., Martis, L. and Serkes K. D. (1991). Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an international study. American Journal of Kidney Diseases, 17(4), 462-471.
  • 19. Kalantar-Zadeh, K., Kleiner, M., Dunne, E., Ahern, K., Nelson, M., Koslowe, R. and Luft, F. C. (1998). Total iron-binding capacity–estimated transferrin correlates with the nutritional subjective global assessment in hemodialysis patients. American Journal of Kidney Diseases, 31(2), 263-272.
  • 20. Daurgidas, J.T. (1994). Chronic Hemodialysis Prescription: A Urea Kinetic Approach. Boston: Brown and Company, 92-120
  • 21. Avram, M. M., Mittman, N., Bonomini, L., Chattopadhyay, J. and Fein, P. (1995). Markers for survival in dialysis: a seven-year prospective study. American Journal of Kidney Diseases, 26(1), 209-219.
  • 22. Saltissi, D., Morgan, C., Knight, B., Chang, W., Rigby, R. and Westhuyzen, J. (2001). Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients. American Journal of Kidney Diseases, 37(6), 1209-1215.
  • 23. Stenver, D. I., Gotfredsern, A., Hilsted, J. and Nielsen, B. (1995). Body composition in hemodialysis patients measured by dual-energy X-ray absorptiometry. American Journal of Nephrology, 15(2), 105-110.
  • 24. Kobayashi, I., Ishimura, E., Kato, Y., Okuno, S., Yamamoto, T., Yamakawa, T. Katsuhito, M., Masaaki, I. and Yoshiki, N. (2010). Geriatric Nutritional Risk Index, a simplified nutritional screening index, is a significant predictor of mortality in chronic dialysis patients. Nephrology Dialysis Transplantation, 25(10), 3361-5.
  • 25. Führ, L.M., Wazlawik, E. and Garcia, M.F. (2015). The predictive value of composite methods of nutritional assessment on mortality among haemodialysis patients. Clinical Nutrition ESPEN, 10(1), e21-e25.
  • 26. Isenring, E.A., Banks, M., Ferguson, M. and Bauer, J.D. (2012). Beyond malnutrition screening: appropriate methods to guide nutrition care for aged care residents. Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381.
  • 27. Kalantar-Zadeh, K., Supasyndh, O., Lehn, R. S., McAllister, C. J. and Kopple, J. D. (2003). Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt/V greater than 1.20. Journal of Renal Nutrition, 13(1), 15-25.
  • 28. Kopple, J. D., Zhu, X., Lew, N. L. and Lowrie, E. G. (1999). Body weight-for-height relationships predict mortality in maintenance hemodialysis patients. Kidney International, 56(3), 1136-1148.
  • 29. Leavey, S. F., McCullough, K., Hecking, E., Goodkin, D., Port, F. K. and Young, E. W. (2001). Body mass index and mortality in ‘healthier’as compared with ‘sicker’haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation, 16(12), 2386-2394.
  • 30. Pollock, C. A., Ibels, L. S., Allen, B. J., Ayass, W., Caterson, R. J., Waugh, D. A., and Mahony, J. F. (1995). Total body nitrogen as a prognostic marker in maintenance dialysis. Journal of the American Society of Nephrology, 6(1), 82-88.
  • 31. Sreedhara, R., Avram, M. M., Blanco, M., Batish, R., Avram, M. M. and Mittman, N. (1996). Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis. American Journal of Kidney Diseases, 28(6), 937-942.
  • 32. Kopple, J. D., Mehrotra, R., Suppasyndh, O. and Kalantar-Zadeh, K. (2002). Observations with regard to the National Kidney Foundation K/DOQI clinical practice guidelines concerning serum transthyretin in chronic renal failure. Clinical Chemistry and Laboratory Medicine, 40(12), 1308-1312.
  • 33. Neyra, N. R., Hakim, R. M., Shyr, Y. and Ikizler, T. A. (2000). Serum transferrin and serum prealbumin are early predictors of serum albumin in chronic hemodialysis patients. Journal of Renal Nutrition, 10(4), 184-190
  • 34. Suffredini, A. F., Fantuzzi, G., Badolato, R., Oppenheim, J. J. and O'grady, N. P. (1999). New insights into the biology of the acute phase response. Journal of Clinical İmmunology, 19(4), 203-214.
  • 35. Kalantar-Zadeh, K. and Kopple, J.D. (2001). Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. American Journal of Kidney Diseases, 38(6), 1343-1350.
  • 36. As’ habi, A., Tabibi, H., Hedayati, M., Mahdavi-Mazdeh, M. and Nozary-Heshmati, B. (2015). Association of malnutrition-inflammation score, dialysis-malnutrition score and serum albumin with novel risk factors for cardiovascular diseases in hemodialysis patients. Renal Failure, 37(1), 113-116.
  • 37. Kara, E., Sahutoglu, T., Ahbap, E., Sakaci, T., Koc, Y., Basturk, T., Sevinc, M., Akgol, C. and Unsal, A. (2016). The predictive value of malnutrition - inflammation score on 1-year mortality in Turkish maintenance hemodialysis patients. Clinical Nephrology, 86(2), 94-99.
  • 38. Baysal, A., Aksoy, M., Bozkurt, N., Merdol, T. K., Pekcan, G., Keçecioğlu, S., Besler, H. T. ve Mercanlıgil, S. (2002). Diyet el kitabı (4. Baskı). Ankara:Hatipboğlu Yayınları.
  • 39. Fouque, D., Vennegoor, M. and Ter Wee, P. (2007). European best practice guideline on nutrition. Nephrol Dial Transplant, 22, 45-87.
  • 40. K/DOQI. (2000). K/DOQI nutrıtıon ın chronıc renal faılure. American Journal of Kidney Diseases, 35(2),1-140.
  • 41. Bebis Nutrition Data Base Software Data Base, (2004). The German Food Code and Nutrient Data Base (BLS II.3, 1999) with additions from USDA-sr and other sources, Istanbul, Turkey.
  • 42. International Business Machines. (2013). Statistical Package for the Social Sciences. Chicago, IL: Statistical Package for the Social Sciences Inc.
  • 43. Johnson, G., Gore, S.M. and Fırth, J. (1999). The Effect of Age, Diabetes and Other Comorbidity on the Survival of Patients on Dialysis: a Systematic Quantitative Overview of the Literature. Nephrology Dialysis Transplant, 14, 2156-2164.
  • 44. İnternet: Malaysian Dialysis and Transplant Registry, Eleventh Report 2003, URL:http://www.webcitation.org/query?url=http%3A%2F%2Fwww.msn.org.my%2Fnrr%2Fnrr%2Freport+2003.htm+&date=2018-07-18, Son Erişim Tarihi:18.02.2018.
  • 45. Foley, R. N., Parfrey, P. S. and Sarnak, M. J. (1998). Epidemiology of cardiovascular disease in chronic renal disease. Journal of the American Society of Nephrology, 9(12), 16-23.
  • 46. Shlipak, M. G., Fried, L. F., Cushman, M., Manolio, T. A., Peterson, D., Stehman-Breen, C., Bleyer, A., Newman, A., Siscovick, D. and Psaty, B. (2005). Cardiovascular mortality risk in chronic kidney disease: comparison of traditional and novel risk factors. The Journal of the American Medical Association, 293(14), 1737-1745.
  • 47. Akgul, A., Bilgic, A., Sezer, S., Arat, Z., Ozdemir, F.N. and Haberal, M. (2008). Low total plasma homocysteine level in relation to malnutrition, inflammation, and outcome in hemodialysis patients. Journal Ren Nutrition, 18, 338–346.
  • 48. Borges, M.C.C., Vogt, B. P. and Martin, L. C. (2017). Jacqueline Costa Teixeira Caramori. Malnutrition Inflammation Score cut-off predicting mortality in maintenance hemodialysis patients. Clinical Nutrition ESPEN, 17, 63-67.
  • 49. Kopple, J.D. (2001). The National Kidney Foundation K/DOQI clinical practice guidelines for dietary protein intake for chronic dialysis patients. American Journal of Kidney Diseases, 38(4), 68-73.
  • 50. Eustace, J. A., Coresh, J., Kutchey, C., Te, P. L., Gimenez, L. F., Scheel, P. J. and Walser, M. (2000). Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia. Kidney International, 57(6), 2527-2538.
  • 51. Koople, J.D. (1995) Nutritional management. Philadelphia: Wıllıams&Wılkıns, 1499-1512.
  • 52. İnternet: Tuğlular, S. Kronik Hemodiyaliz Hastalarında Hipoalbuminemi. URL: http://www.webcitation.org/query?url=http%3A%2F%2Fwww.tsn.org.tr%2Fdocuments%2Fmevzuat_egitim%2Fhipoalbuminemi&date=2018-01-04, Son Erişim Tarihi: 18.12.2017.
  • 53. Özyiğit, F.P. (1998). Kronik böbrek yetmezliği ile hemodiyalize giren hastalarda farklı düzeyde protein alımının beslenme durumu ve bazı biyokimyasal bulgulara etkisi üzerine bir araştırma. Bilim Uzmanlığı Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 54. Carvalho, K.T., Sılva, B.M.I. and Bergman, R. (2004). Nutritional profile of patients with chronic renal failure. Journal of Renal Nutrition, 14, 97-100.
  • 55. Erek, E. (2005). Nefroloji (Beşinci Baskı). Ankara: Nobel Tıp Kitapevleri, 145-146.
  • 56. Marcén, R., Teruel, J. L., De La Cal, M. A. and Gàmez, C. (1997). The impact of malnutrition in morbidity and mortality in stable haemodialysis patients. Spanish Cooperative Study of Nutrition in Hemodialysis. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association, 12(11), 2324-2331.
  • 57. Acchıarda, S. and Smıth, S. O. (2000). Effects of nutrition on morbidity and mortality in hemodialysis paients. Dialysis and Transplantation, 29, 614-619.
  • 58. Güllülü, M. (2001). Lipidler ve böbrek. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 60, 1-6.
  • 59. Gretz, N., Lasserre, J. J., Hocker, A. and Strauch, M. (1991). Effect of low-protein diet on renal function: are there definite conclusions from adult studies?. Pediatric Nephrology, 5(4), 492-495.
  • 60. Baugh, M.E., Stoltz, M. L., VanBeber, A. D. and Gorman, M. A. (2001). Are lipid values and BMI related to hospitalizations in the hemodialysis population? Journal of Renal Nutrition, 11(1), 37-45.
  • 61. Krauss, R., Eckel, M., Howard, B., Appel, L., Danıels, S., Deckelbaum, R., Erdman, J., Etherton, P., Goldberg, I., Kotchen, T., Lıchtensteın, A., Mıtch, W., Mullıs, R., Robınson, K., Rosett, J., Jeor, S., Suttıe, J., Trıbble, D. and Bazzarre, T. (2000). AHA Dietery Guidelines: Revision 2000: A Statement for Helthcare Professionals from the Nutrition Committee of the American Heart Association. Circulation, 102, 2296-2311.
  • 62. Aksoy, M. (2000). Beslenme biyokimyası. Ankara: Hatiboğlu Yayınevi.
  • 63. Cupisti, A., D'Alessandro, C., Valeri, A., Capitanini, A., Meola, M., Betti, G., and Barsotti, G. (2010). Food intake and nutritional status in stable hemodialysis patients. Renal Failure, 32(1), 47-54.
  • 64. Lou, L., Campos, B., Gimeno, J.A., Caverní, A. and Boned, B. (2007). Main dietari intake deficits in hemodialysis patients: approach to a healthy dietary model based on the Mediterranean diet. Nefrologia, 27(1), 38-45.
  • 65. Mahan, L. K. (2004). Krause's food, nutrition, & diet therapy (Vol. 11). S. Escott-Stump (Ed.). Philadelphia: Saunders.
  • 66. Krishnamurthy, V.M., Wei, G., Baird, B.C., Murtaugh, M., Chonchol, M.B., Raphael, K.L., Greene, T. and Beddhu, S. (2012). High dietary fiber intake is associated with decreased inflammation and all-cause mortalityin patients with chronic kidney disease. Kidney Int, 81, 300–306.
  • 67. Bossola, M., Leo, A., Viola, A., Carlomagno, G., Monteburini, T., Cenerelli, S., Santarelli, S., Boggi, R., Miggiano, G., Vulpio, C., Mele, C. and Tazza, L. (2012). Dietary intake of macronutrients and fiber in Mediterranean patients on chronic hemodialysis. Journal of Nephrology, 26(5), 912-918.
  • 68. Çiloğlu, H. (2008) Hemodiyaliz ve periton diyalizi hastalarının beslenme ile serum folik asit ve homosistein düzeylerinin incelenmesine yönelik bir çalışma. Yüksek Lisans Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 69. Çalışkan, Y. ve Yıldız, A. (2010). Kronik böbrek hastalığında beslenme desteği. İç Hastalıkları Dergisi, 17, 247-256.
  • 70. Baysal, A. (2009). Beslenme. 12. Baskı. Ankara: Hatipoğlu Yayınları.
  • 71. Schafer, I. (2006). Trombotik bozukluklar: hiperkoagülabilite durumları (çev. F. Büyükkeçeci), S. Ünal (Editör). İstanbul: Güneş Kitabevi, 1082-1087.
  • 72. Madore, F. (2003). Uremia-related metabolic cardiac risk factors in chronic kidney disease. Seminars in Dialysis, 16, 148-156.
  • 73. Morena, M., Crıstol, J.P., Bosc, J.Y., Tetta, C., Forret, G., Leger, C.L., Delcourt, C., Popoz, L., Descomps, B. and Canoud, B. (2002). Convective and diffusive losses of vitamin c duruing hemodiafiltration session: a contributive factors to oxidative stres in hemodialysis patients. Nephrology Dialysis Transplantation, 17(3), 422-427.
  • 74. Uslu, S., Çolak, Ö., Demir, T.A., Berber, A., Özdemir, G. ve Alataş, Ö. (2005). Hemodiyaliz Hastalarında Kardiak Belirteçler ve İz Elementler. Türk Klinik Biyokimya Dergisi, 3(3), 85-93.
  • 75. Köseler, E. (2015). Kronik Böbrek Yetmezlikli Hepatiti Olan Ve Olmayan Diyaliz Hastalarının Beslenme Durumlarının, Bazı Biyokimyasal Bulgularının, İştah Ve Yaşam Kalite Düzeylerinin Belirlenmesi. Doktora Tezi, Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 76. K/DOQI. (2005). K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. American Journal of Kidney Diseases, 45(3), 1-153.
  • 77. Foley, R. N. and Parfrey, P. S. (1998). Cardiovascular disease and mortality in ESRD. Journal of Nephrology, 11(5), 239-245.
  • 78. Yılmaz, F.M. ve Çelebi, N. (2003). Bir grup kronik böbrek yetmezliği hastasında hemodiyalizin c, e ve a vitamini düzeyleri üzerine olan etkisi. Türk Biyokimya Dergisi, 28(2), 35-39.
  • 79. Galle, J. (2001). Oxidative Stress in Chronic Renal Failure. Nephrology Dialysis Transplantation, 16, 2135-2137.
  • 80. Allen, K.L., Mıskulın, D., Yan, G., Dwyer, J., Frydrych, A., Leung, J. and Poole, D. (2002). Association of nutritional markers with physical and mental helath status in prevalent hemodialysis patients from the hemo study. Journal Of Renal Nutrition, 12, 160-169.
  • 81. Sevim, Y. (t.y.). Hemodiyaliz hastalarında beslenme durumu ve malnutrisyon. Yüksek Lisan Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul
  • 82. Giancaspro, V., Nuzziello, M., Pallotta, G., Sacchetti, A. and Petrarulo, F. (2000). Intravenous ascorbic acid in hemodialysis patients with functional iron deficiency: a clinical trial. Journal of Nephrology, 13(6), 444-449.
  • 83. Tarng, D. C. and Huang, T. P. (1998). A parallel, comparative study of intravenous iron versus intravenous ascorbic acid for erythropoietin-hyporesponsive anaemia in haemodialysis patients with iron overload. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association, 13(11), 2867-2872.
  • 84. Chevalier, C., Liepa, G., Murphy, M.D. (2002). The effect of zinc supplementation on serum zinc and cholesterol concentration in hemodialysis patients. Journal of Renal Nutrition, 12, 183-189.
  • 85. Şanlier, N. ve Demircioğlu, Y. (2007). Correlation of dietary intakes and biochemical determinates of nutrition in hemodialysis patients. Renal Failure, 29(2), 213-218.
  • 86. Kang, J.H., Cook, N.R., Manson, J.E. (2009). Vitamin E, Vitamin C, beta carotene, and cognitive function among women with or at risk of cardiovascular disease. The Women’s Antioxidant and Cardiovascular Study. Circulation, 119, 2772-2780.
  • 87. Saatçı, Ü. (1993). Hemodiyaliz Uygulanan Hastalarda Beslenme. Hemodiyaliz, Yanık ve Transplantasyon, 7, 97-101. 88. Lim, V. S., Ikizler, T. A., Raj, D. S. and Flanigan, M. J. (2005). Does hemodialysis increase protein breakdown? Dissociation between whole-body amino acid turnover and regional muscle kinetics. Journal of the American Society of Nephrology, 16(4), 862-868
  • 89. Kalantar-Zadeh, K. and Kopple, J.D. (2003b). Trace elements and vitamins in maintenance dialysis patients. Advances in Renal Replacement Therapy, 10(3), 170-182.
  • 90. Harvinder, G.S., Swee, W.C., Karupaiah, T., Sahathevan, S., Chinna, K., Ahmad, G., Bavanandan, S. and Goh, B.L. (2016). Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis–related protein-energy wasting in Malaysia. Asia Pacific Journal of Clinical Nutrition, 25(1), 26-33.

The relationship between food intake and malnutrition inflammation score in patients receiving hemodialysis treatment

Year 2021, Volume: 46 Issue: 2, 418 - 429, 30.06.2021
https://doi.org/10.17826/cumj.794910

Abstract

Purpose: The aim of this study is to evaluate the relationship between nutritional status and malnutrition inflammation score by examining the food consumption of hemodialysis patients.
Materials and Methods: The study was carried out in 49 hemodialysis patients (25 male, 24 female) in 18-65 years. The body composition of the patients was measured with a bioimpedance device, the malnutrition inflammation score (MIS) questionnaire was applied, and their food consumption for three days was taken by the researcher.
Results: The mean age of the patients was 47.6 ± 11.39 years, MIS was11.3 ± 4.10 and 85.7% of them were malnourished. It was found that the patients received 23.1±10.53 kcal/kg/day energy and 0.83±0.39 g/kg/day protein. According to the National Kidney Foundation (NKF), 80% of male patients and 83.7% of female patients receive insufficient energy. The 84% of male patients and all female patients take insufficient protein according to NKF. Daily intake of thiamine, riboflavin, niacin, vitamin B6, folic acid, vitamin C, zinc, iron and calcium was below the NKF recommendations. A significant negative correlation was found between BMI and body composition of the patients.
Conclusion: It is remarkable that the daily energy, protein and some nutrient intake of the patients was quite lower than the values recommended for hemodialysis patients.
High MIS may be associated with malnutrition due to insufficient energy and nutrient intake.

References

  • 1. Akpolat, T., Utaş, C. ve Süleymanlar, G. (2007). Nefroloji el kitabı (4. Baskı). İstanbul: Nobel Tıp Kitabevi.
  • 2. Weekes, C. E., Elia, M. and Emery, P. W. (2004). The development, validation and reliability of a nutrition screening tool based on the recommendations of the British Association for Parenteral and Enteral Nutrition (BAPEN). Clinical Nutrition, 23(5), 1104-1112.
  • 3. Lauılle, M. and Fauque, D. (2000). Nutritional aspects in hemodialysis. Kidney International, 76, 133-139.
  • 4. Heaf, J. (2003). High transport and malnutrition-inflammation-atherosclerosis (MIA) syndrome. Peritoneal Dialysis International, 23(2), 109-110.
  • 5. Mehrotra, R. and Kopple, J. D. (2001). Nutritional management of maintenance dialysis patients: why aren't we doing better? Annual Review of Nutrition, 21(1), 343-379.
  • 6. Kopple, J.D. (1999). Pathophysiology of protein-energy wasting in chronic renal failure. The Journal of Nutrition, 129(1), 247-251.
  • 7. Qureshi, A. R., Alvestrand, A., Danielsson, A., Divino-Filho, J. C., Gutierrez, A., Lindholm, B. and Bergström, J. (1998). Factors predicting malnutrition in hemodialysis patients: a cross-sectional study. Kidney International, 53(3), 773-782.
  • 8. Demir, M. ve Tonbul, H.Z. (2005). Son dönem böbrek yetmezlikli hastalarda malnütrisyoninflamasyon-ateroskleroz (MİA Sendromu). Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 4(14), 160-165.
  • 9. O'Keefe, A. and Daigle, N. W. (2002). A new approach to classifying malnutrition in the hemodialysis patient. Journal of Renal Nutrition, 12(4), 248-255.
  • 10. Stenvinkel, P., Heimbürger, O., Lindholm, B., Kaysen, G. A. and Bergström, J. (2000). Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome). Nephrology Dialysis Transplantation, 15(7), 953-960.
  • 11. Kalantar-Zadeh, K., Block, G., McAllister, C. J., Humphreys, M. H. and Kopple, J. D. (2004). Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. The American Journal of Clinical Nutrition, 80(2), 299-307.
  • 12. Stenvinkel, P., Heimburger, O, Paultre, F. (1999). Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney International, 55, 1899-1911.
  • 13. Yeun, J.Y. and Kaysen, G.A. (1998). Factors influencing serum albumin in dialysis patients. American Journal of Kidney Diseases, 32(6), 118-125.
  • 14. Kaizu, Y., Kimura, M., Yoneyama, T., Miyaji, K., Hibi, I. and Kumagai, H. (1998). Interleukin-6 may mediate malnutrition in chronic hemodialysis patients. American Journal of Kidney Diseases, 31(1), 93-100.
  • 15. Kalantar-Zadeh, K., Ikizler, T. A., Block, G., Avram, M. M. and Kopple, J. D. (2003). Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. American Journal of Kidney Diseases, 42(5), 864-881.
  • 16. Kalantar-Zadeh, K., Block, G., Humphreys, M.H. and Kopple, J.D. (2003). Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney International, 63, 793-808
  • 17. Lowrie, E. G. and Lew, N. L. (1990). Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. American Journal of Kidney Diseases, 15(5), 458-482.
  • 18. Young, G. A., Kopple, J. D., Lindholm, B., Vonesh, E. F., De Vecchi, A., Scalamogna, A., Castelnova, C., Oreopoulos, D. G., Anderson, G. H., Bergstrom, J., DiChiro, J., Gentile, D., Nissenson, A., Sakhrani, L., Brownjohn, A. M., Nolph, K. D., Prowant, B. F., Algrim, C. E., Martis, L. and Serkes K. D. (1991). Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an international study. American Journal of Kidney Diseases, 17(4), 462-471.
  • 19. Kalantar-Zadeh, K., Kleiner, M., Dunne, E., Ahern, K., Nelson, M., Koslowe, R. and Luft, F. C. (1998). Total iron-binding capacity–estimated transferrin correlates with the nutritional subjective global assessment in hemodialysis patients. American Journal of Kidney Diseases, 31(2), 263-272.
  • 20. Daurgidas, J.T. (1994). Chronic Hemodialysis Prescription: A Urea Kinetic Approach. Boston: Brown and Company, 92-120
  • 21. Avram, M. M., Mittman, N., Bonomini, L., Chattopadhyay, J. and Fein, P. (1995). Markers for survival in dialysis: a seven-year prospective study. American Journal of Kidney Diseases, 26(1), 209-219.
  • 22. Saltissi, D., Morgan, C., Knight, B., Chang, W., Rigby, R. and Westhuyzen, J. (2001). Effect of lipid-lowering dietary recommendations on the nutritional intake and lipid profiles of chronic peritoneal dialysis and hemodialysis patients. American Journal of Kidney Diseases, 37(6), 1209-1215.
  • 23. Stenver, D. I., Gotfredsern, A., Hilsted, J. and Nielsen, B. (1995). Body composition in hemodialysis patients measured by dual-energy X-ray absorptiometry. American Journal of Nephrology, 15(2), 105-110.
  • 24. Kobayashi, I., Ishimura, E., Kato, Y., Okuno, S., Yamamoto, T., Yamakawa, T. Katsuhito, M., Masaaki, I. and Yoshiki, N. (2010). Geriatric Nutritional Risk Index, a simplified nutritional screening index, is a significant predictor of mortality in chronic dialysis patients. Nephrology Dialysis Transplantation, 25(10), 3361-5.
  • 25. Führ, L.M., Wazlawik, E. and Garcia, M.F. (2015). The predictive value of composite methods of nutritional assessment on mortality among haemodialysis patients. Clinical Nutrition ESPEN, 10(1), e21-e25.
  • 26. Isenring, E.A., Banks, M., Ferguson, M. and Bauer, J.D. (2012). Beyond malnutrition screening: appropriate methods to guide nutrition care for aged care residents. Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381.
  • 27. Kalantar-Zadeh, K., Supasyndh, O., Lehn, R. S., McAllister, C. J. and Kopple, J. D. (2003). Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt/V greater than 1.20. Journal of Renal Nutrition, 13(1), 15-25.
  • 28. Kopple, J. D., Zhu, X., Lew, N. L. and Lowrie, E. G. (1999). Body weight-for-height relationships predict mortality in maintenance hemodialysis patients. Kidney International, 56(3), 1136-1148.
  • 29. Leavey, S. F., McCullough, K., Hecking, E., Goodkin, D., Port, F. K. and Young, E. W. (2001). Body mass index and mortality in ‘healthier’as compared with ‘sicker’haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation, 16(12), 2386-2394.
  • 30. Pollock, C. A., Ibels, L. S., Allen, B. J., Ayass, W., Caterson, R. J., Waugh, D. A., and Mahony, J. F. (1995). Total body nitrogen as a prognostic marker in maintenance dialysis. Journal of the American Society of Nephrology, 6(1), 82-88.
  • 31. Sreedhara, R., Avram, M. M., Blanco, M., Batish, R., Avram, M. M. and Mittman, N. (1996). Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis. American Journal of Kidney Diseases, 28(6), 937-942.
  • 32. Kopple, J. D., Mehrotra, R., Suppasyndh, O. and Kalantar-Zadeh, K. (2002). Observations with regard to the National Kidney Foundation K/DOQI clinical practice guidelines concerning serum transthyretin in chronic renal failure. Clinical Chemistry and Laboratory Medicine, 40(12), 1308-1312.
  • 33. Neyra, N. R., Hakim, R. M., Shyr, Y. and Ikizler, T. A. (2000). Serum transferrin and serum prealbumin are early predictors of serum albumin in chronic hemodialysis patients. Journal of Renal Nutrition, 10(4), 184-190
  • 34. Suffredini, A. F., Fantuzzi, G., Badolato, R., Oppenheim, J. J. and O'grady, N. P. (1999). New insights into the biology of the acute phase response. Journal of Clinical İmmunology, 19(4), 203-214.
  • 35. Kalantar-Zadeh, K. and Kopple, J.D. (2001). Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. American Journal of Kidney Diseases, 38(6), 1343-1350.
  • 36. As’ habi, A., Tabibi, H., Hedayati, M., Mahdavi-Mazdeh, M. and Nozary-Heshmati, B. (2015). Association of malnutrition-inflammation score, dialysis-malnutrition score and serum albumin with novel risk factors for cardiovascular diseases in hemodialysis patients. Renal Failure, 37(1), 113-116.
  • 37. Kara, E., Sahutoglu, T., Ahbap, E., Sakaci, T., Koc, Y., Basturk, T., Sevinc, M., Akgol, C. and Unsal, A. (2016). The predictive value of malnutrition - inflammation score on 1-year mortality in Turkish maintenance hemodialysis patients. Clinical Nephrology, 86(2), 94-99.
  • 38. Baysal, A., Aksoy, M., Bozkurt, N., Merdol, T. K., Pekcan, G., Keçecioğlu, S., Besler, H. T. ve Mercanlıgil, S. (2002). Diyet el kitabı (4. Baskı). Ankara:Hatipboğlu Yayınları.
  • 39. Fouque, D., Vennegoor, M. and Ter Wee, P. (2007). European best practice guideline on nutrition. Nephrol Dial Transplant, 22, 45-87.
  • 40. K/DOQI. (2000). K/DOQI nutrıtıon ın chronıc renal faılure. American Journal of Kidney Diseases, 35(2),1-140.
  • 41. Bebis Nutrition Data Base Software Data Base, (2004). The German Food Code and Nutrient Data Base (BLS II.3, 1999) with additions from USDA-sr and other sources, Istanbul, Turkey.
  • 42. International Business Machines. (2013). Statistical Package for the Social Sciences. Chicago, IL: Statistical Package for the Social Sciences Inc.
  • 43. Johnson, G., Gore, S.M. and Fırth, J. (1999). The Effect of Age, Diabetes and Other Comorbidity on the Survival of Patients on Dialysis: a Systematic Quantitative Overview of the Literature. Nephrology Dialysis Transplant, 14, 2156-2164.
  • 44. İnternet: Malaysian Dialysis and Transplant Registry, Eleventh Report 2003, URL:http://www.webcitation.org/query?url=http%3A%2F%2Fwww.msn.org.my%2Fnrr%2Fnrr%2Freport+2003.htm+&date=2018-07-18, Son Erişim Tarihi:18.02.2018.
  • 45. Foley, R. N., Parfrey, P. S. and Sarnak, M. J. (1998). Epidemiology of cardiovascular disease in chronic renal disease. Journal of the American Society of Nephrology, 9(12), 16-23.
  • 46. Shlipak, M. G., Fried, L. F., Cushman, M., Manolio, T. A., Peterson, D., Stehman-Breen, C., Bleyer, A., Newman, A., Siscovick, D. and Psaty, B. (2005). Cardiovascular mortality risk in chronic kidney disease: comparison of traditional and novel risk factors. The Journal of the American Medical Association, 293(14), 1737-1745.
  • 47. Akgul, A., Bilgic, A., Sezer, S., Arat, Z., Ozdemir, F.N. and Haberal, M. (2008). Low total plasma homocysteine level in relation to malnutrition, inflammation, and outcome in hemodialysis patients. Journal Ren Nutrition, 18, 338–346.
  • 48. Borges, M.C.C., Vogt, B. P. and Martin, L. C. (2017). Jacqueline Costa Teixeira Caramori. Malnutrition Inflammation Score cut-off predicting mortality in maintenance hemodialysis patients. Clinical Nutrition ESPEN, 17, 63-67.
  • 49. Kopple, J.D. (2001). The National Kidney Foundation K/DOQI clinical practice guidelines for dietary protein intake for chronic dialysis patients. American Journal of Kidney Diseases, 38(4), 68-73.
  • 50. Eustace, J. A., Coresh, J., Kutchey, C., Te, P. L., Gimenez, L. F., Scheel, P. J. and Walser, M. (2000). Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia. Kidney International, 57(6), 2527-2538.
  • 51. Koople, J.D. (1995) Nutritional management. Philadelphia: Wıllıams&Wılkıns, 1499-1512.
  • 52. İnternet: Tuğlular, S. Kronik Hemodiyaliz Hastalarında Hipoalbuminemi. URL: http://www.webcitation.org/query?url=http%3A%2F%2Fwww.tsn.org.tr%2Fdocuments%2Fmevzuat_egitim%2Fhipoalbuminemi&date=2018-01-04, Son Erişim Tarihi: 18.12.2017.
  • 53. Özyiğit, F.P. (1998). Kronik böbrek yetmezliği ile hemodiyalize giren hastalarda farklı düzeyde protein alımının beslenme durumu ve bazı biyokimyasal bulgulara etkisi üzerine bir araştırma. Bilim Uzmanlığı Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 54. Carvalho, K.T., Sılva, B.M.I. and Bergman, R. (2004). Nutritional profile of patients with chronic renal failure. Journal of Renal Nutrition, 14, 97-100.
  • 55. Erek, E. (2005). Nefroloji (Beşinci Baskı). Ankara: Nobel Tıp Kitapevleri, 145-146.
  • 56. Marcén, R., Teruel, J. L., De La Cal, M. A. and Gàmez, C. (1997). The impact of malnutrition in morbidity and mortality in stable haemodialysis patients. Spanish Cooperative Study of Nutrition in Hemodialysis. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association, 12(11), 2324-2331.
  • 57. Acchıarda, S. and Smıth, S. O. (2000). Effects of nutrition on morbidity and mortality in hemodialysis paients. Dialysis and Transplantation, 29, 614-619.
  • 58. Güllülü, M. (2001). Lipidler ve böbrek. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 60, 1-6.
  • 59. Gretz, N., Lasserre, J. J., Hocker, A. and Strauch, M. (1991). Effect of low-protein diet on renal function: are there definite conclusions from adult studies?. Pediatric Nephrology, 5(4), 492-495.
  • 60. Baugh, M.E., Stoltz, M. L., VanBeber, A. D. and Gorman, M. A. (2001). Are lipid values and BMI related to hospitalizations in the hemodialysis population? Journal of Renal Nutrition, 11(1), 37-45.
  • 61. Krauss, R., Eckel, M., Howard, B., Appel, L., Danıels, S., Deckelbaum, R., Erdman, J., Etherton, P., Goldberg, I., Kotchen, T., Lıchtensteın, A., Mıtch, W., Mullıs, R., Robınson, K., Rosett, J., Jeor, S., Suttıe, J., Trıbble, D. and Bazzarre, T. (2000). AHA Dietery Guidelines: Revision 2000: A Statement for Helthcare Professionals from the Nutrition Committee of the American Heart Association. Circulation, 102, 2296-2311.
  • 62. Aksoy, M. (2000). Beslenme biyokimyası. Ankara: Hatiboğlu Yayınevi.
  • 63. Cupisti, A., D'Alessandro, C., Valeri, A., Capitanini, A., Meola, M., Betti, G., and Barsotti, G. (2010). Food intake and nutritional status in stable hemodialysis patients. Renal Failure, 32(1), 47-54.
  • 64. Lou, L., Campos, B., Gimeno, J.A., Caverní, A. and Boned, B. (2007). Main dietari intake deficits in hemodialysis patients: approach to a healthy dietary model based on the Mediterranean diet. Nefrologia, 27(1), 38-45.
  • 65. Mahan, L. K. (2004). Krause's food, nutrition, & diet therapy (Vol. 11). S. Escott-Stump (Ed.). Philadelphia: Saunders.
  • 66. Krishnamurthy, V.M., Wei, G., Baird, B.C., Murtaugh, M., Chonchol, M.B., Raphael, K.L., Greene, T. and Beddhu, S. (2012). High dietary fiber intake is associated with decreased inflammation and all-cause mortalityin patients with chronic kidney disease. Kidney Int, 81, 300–306.
  • 67. Bossola, M., Leo, A., Viola, A., Carlomagno, G., Monteburini, T., Cenerelli, S., Santarelli, S., Boggi, R., Miggiano, G., Vulpio, C., Mele, C. and Tazza, L. (2012). Dietary intake of macronutrients and fiber in Mediterranean patients on chronic hemodialysis. Journal of Nephrology, 26(5), 912-918.
  • 68. Çiloğlu, H. (2008) Hemodiyaliz ve periton diyalizi hastalarının beslenme ile serum folik asit ve homosistein düzeylerinin incelenmesine yönelik bir çalışma. Yüksek Lisans Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 69. Çalışkan, Y. ve Yıldız, A. (2010). Kronik böbrek hastalığında beslenme desteği. İç Hastalıkları Dergisi, 17, 247-256.
  • 70. Baysal, A. (2009). Beslenme. 12. Baskı. Ankara: Hatipoğlu Yayınları.
  • 71. Schafer, I. (2006). Trombotik bozukluklar: hiperkoagülabilite durumları (çev. F. Büyükkeçeci), S. Ünal (Editör). İstanbul: Güneş Kitabevi, 1082-1087.
  • 72. Madore, F. (2003). Uremia-related metabolic cardiac risk factors in chronic kidney disease. Seminars in Dialysis, 16, 148-156.
  • 73. Morena, M., Crıstol, J.P., Bosc, J.Y., Tetta, C., Forret, G., Leger, C.L., Delcourt, C., Popoz, L., Descomps, B. and Canoud, B. (2002). Convective and diffusive losses of vitamin c duruing hemodiafiltration session: a contributive factors to oxidative stres in hemodialysis patients. Nephrology Dialysis Transplantation, 17(3), 422-427.
  • 74. Uslu, S., Çolak, Ö., Demir, T.A., Berber, A., Özdemir, G. ve Alataş, Ö. (2005). Hemodiyaliz Hastalarında Kardiak Belirteçler ve İz Elementler. Türk Klinik Biyokimya Dergisi, 3(3), 85-93.
  • 75. Köseler, E. (2015). Kronik Böbrek Yetmezlikli Hepatiti Olan Ve Olmayan Diyaliz Hastalarının Beslenme Durumlarının, Bazı Biyokimyasal Bulgularının, İştah Ve Yaşam Kalite Düzeylerinin Belirlenmesi. Doktora Tezi, Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 76. K/DOQI. (2005). K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. American Journal of Kidney Diseases, 45(3), 1-153.
  • 77. Foley, R. N. and Parfrey, P. S. (1998). Cardiovascular disease and mortality in ESRD. Journal of Nephrology, 11(5), 239-245.
  • 78. Yılmaz, F.M. ve Çelebi, N. (2003). Bir grup kronik böbrek yetmezliği hastasında hemodiyalizin c, e ve a vitamini düzeyleri üzerine olan etkisi. Türk Biyokimya Dergisi, 28(2), 35-39.
  • 79. Galle, J. (2001). Oxidative Stress in Chronic Renal Failure. Nephrology Dialysis Transplantation, 16, 2135-2137.
  • 80. Allen, K.L., Mıskulın, D., Yan, G., Dwyer, J., Frydrych, A., Leung, J. and Poole, D. (2002). Association of nutritional markers with physical and mental helath status in prevalent hemodialysis patients from the hemo study. Journal Of Renal Nutrition, 12, 160-169.
  • 81. Sevim, Y. (t.y.). Hemodiyaliz hastalarında beslenme durumu ve malnutrisyon. Yüksek Lisan Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul
  • 82. Giancaspro, V., Nuzziello, M., Pallotta, G., Sacchetti, A. and Petrarulo, F. (2000). Intravenous ascorbic acid in hemodialysis patients with functional iron deficiency: a clinical trial. Journal of Nephrology, 13(6), 444-449.
  • 83. Tarng, D. C. and Huang, T. P. (1998). A parallel, comparative study of intravenous iron versus intravenous ascorbic acid for erythropoietin-hyporesponsive anaemia in haemodialysis patients with iron overload. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association, 13(11), 2867-2872.
  • 84. Chevalier, C., Liepa, G., Murphy, M.D. (2002). The effect of zinc supplementation on serum zinc and cholesterol concentration in hemodialysis patients. Journal of Renal Nutrition, 12, 183-189.
  • 85. Şanlier, N. ve Demircioğlu, Y. (2007). Correlation of dietary intakes and biochemical determinates of nutrition in hemodialysis patients. Renal Failure, 29(2), 213-218.
  • 86. Kang, J.H., Cook, N.R., Manson, J.E. (2009). Vitamin E, Vitamin C, beta carotene, and cognitive function among women with or at risk of cardiovascular disease. The Women’s Antioxidant and Cardiovascular Study. Circulation, 119, 2772-2780.
  • 87. Saatçı, Ü. (1993). Hemodiyaliz Uygulanan Hastalarda Beslenme. Hemodiyaliz, Yanık ve Transplantasyon, 7, 97-101. 88. Lim, V. S., Ikizler, T. A., Raj, D. S. and Flanigan, M. J. (2005). Does hemodialysis increase protein breakdown? Dissociation between whole-body amino acid turnover and regional muscle kinetics. Journal of the American Society of Nephrology, 16(4), 862-868
  • 89. Kalantar-Zadeh, K. and Kopple, J.D. (2003b). Trace elements and vitamins in maintenance dialysis patients. Advances in Renal Replacement Therapy, 10(3), 170-182.
  • 90. Harvinder, G.S., Swee, W.C., Karupaiah, T., Sahathevan, S., Chinna, K., Ahmad, G., Bavanandan, S. and Goh, B.L. (2016). Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis–related protein-energy wasting in Malaysia. Asia Pacific Journal of Clinical Nutrition, 25(1), 26-33.
There are 89 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Hacer Alataş 0000-0002-6441-0362

Hilal Yıldıran 0000-0001-7956-5087

Ahmet Yalçın 0000-0002-9708-0988

Publication Date June 30, 2021
Acceptance Date February 9, 2021
Published in Issue Year 2021 Volume: 46 Issue: 2

Cite

MLA Alataş, Hacer et al. “Hemodiyaliz Tedavisi Alan Hastalarda Besin alımı Ile malnütrisyon Inflamasyon Skoru arasındaki ilişki”. Cukurova Medical Journal, vol. 46, no. 2, 2021, pp. 418-29, doi:10.17826/cumj.794910.