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ABSTRACT
Elevated protein catabolism and protein malnutrition products, dialysis treatment should be initiated. Hem
are common in patients with chronic kidney disease dialysis (HD) is the most common renal treatment
(CKD) and end-stage stage renal disease (ESRD). The today. Despite the benefits of HD in prolonging the
underlying etiology includes, but is not limited to, survival of patients with CKD, the conditions imposed
metabolic acidosis
osis intestinal dysbiosis; systemic by the disease and dialysis therapy result in a series of
inflammation with activation of complements, organic changes, with acute and chronic
endothelin-1 and renin-angiotensin
angiotensin-aldosterone complications and nutritional changes. Additionally,
(RAAS) axis; anabolic hormone resistance; energy dialysis treatment is associated with high rates of
expenditure elevation; and uremic toxin accumulation. hospitalization and increased mortality. Individuals
All of these derangements can further worsen kidney undergoing dialysis have a significant prevalence of
function, leading to poor patient outcomes. Many of malnutrition, which is classified as mild, moderate,
these CKD-related
related derangements can be prevented and severe. The cause of malnutrition is multifactorial
and substantially reversed, representing an area of and includes:
ludes: inadequate food intake, hormonal and
great potential to improve CKD and ESRD care. This gastrointestinal disorders, dietary restrictions, drugs
review integrates known information
formation and recent that alter nutrient absorption, insufficient dialysis, and
advances in the area of protein nutrition and constant presence of associated diseases. Furthermore,
malnutrition in CKD and ESRD. Management uremia, acidosis, and HD procedure per se are hyper
recommendations are summarized. Thorough catabolic and associated with the presence of an
understanding the pathogenesis and etiology of inflammatory state. Malnutrition is considered a
protein malnutrition in CKD and ESRD patients will marker of poor prognosis in CKD.
undoubtedlyly facilitate the design and development of
more effective strategies to optimize protein nutrition Aims and Objectives:
and improve outcomes. To determine the prevalence of malnutrition
among CKD patient on hemodialysis.
Keywords: protein nutrition; protein catabolism; To determine the he impact of demographic
chronic kidney disease; dialysis; acidosis; socioeconomic factors on malnutrition indicators.
inflammation; hormonal derangements; ure
uremic toxins To determine the prevalence of
chronic kidney disease complications.
INTRODUCTION To evaluate the diet & fluid
Chronic kidney disease (CKD) is currently a public compliance among hemodialysis patients.
health problem. CKD is a slow, progressive, and irre
irre- And to clarify the correlation between dietary
diet
versible loss of kidney function. Because this loss is intake and malnutrition among hemodialysis
slow and progressive, it results in an adaptive process patients.
in which the patient remains asymptomatic for some
time. However, when the kidneys can no longer
adequately remove the metabolic degradation
Biochemical tests Albumin < 4.0 g/dL Creatinine < 10 mg/dL < 165 mg/dL Cholesterol
There was a marked increase in the prevalence of Gastrointestinal symptoms lead to inadequate food
CKD complications among hemodialysis patients intake and may interfere significantly with the
at DR. B. R. A. Memorial Hospital: patients nutritional status.
A. Anemia – male – 62.0% - female – 38.0%
B. Hypertension (72.0%), The majority (56.0%) of hemodialysis patients
C. High turnover bone disease –hypocalcaemia
hypocalcaemia- didn’t have any diet regimen and about (44.0%) of
72.0% hypophosphatemia – 72.0% patients deviated from their fluid restrictions.
D. Hyperkalemia (20.0%),
E. Diabetes mellitus (36%). Abbreviations:-
UPS Proteasome-ubiquitin
ubiquitin system
And the presence of this co-morbidity
morbidity has a CKD Chronic kidney disease
significant adverse impact on patients survival. ESRD End-stage
stage renal disease
HBV High biological value
There was a significant positive correlation IS Indoxyl sulfate
between patients age (yrs), marital status, and pCS p-Cresyl
Cresyl sulfate
monthly income (NIS) with BMI. The data HCl Hydrogen chloride
suggests that demographic
phic socioeconomic factors H2SO4 Sulfuric acid
could contribute to a higher percentage of H3PO4 Phosphoric acids
malnutrition. NaHCO3 Sodium bicarbonate
TWEAK NF-related
related weak inducer of apoptosis
IL-1 Interleukin-1
IL-6 Interleukin-6