Effect of high bicarbonate hemodialysis solution on biochemical parameters and anthropometric indices.
Nutrition
fat mass
hemodialysis patients
high bicarbonate dialyzer
Journal
Hemodialysis international. International Symposium on Home Hemodialysis
ISSN: 1542-4758
Titre abrégé: Hemodial Int
Pays: Canada
ID NLM: 101093910
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
12
02
2020
revised:
28
04
2020
accepted:
28
04
2020
pubmed:
19
5
2020
medline:
19
3
2021
entrez:
19
5
2020
Statut:
ppublish
Résumé
Protein energy wasting is an adverse consequence of renal failure, which is correlated with increased mortality and morbidity. Metabolic acidosis has a major role in the development of protein energy wasting in hemodialysis patients. Every effort that could ameliorate this catabolic state would be beneficial to stabilize body composition. The aim of this study was to investigate the possible beneficial effects of high bicarbonate dialysis on anthropometric indices and biochemical parameters of nutrition. Fifty-six hemodialysis patients were randomly enrolled in two groups: an intervention group that underwent hemodialysis for 6 months with high bicarbonate dialysate concentration (36 mmol/L, N = 26) and a control group that underwent hemodialysis using a bicarbonate dialysate concentration of 30 mmol/L (N = 30). Biochemical parameters of nutrition and weight, body mass index (BMI), total body water, percent body fat, and other anthropometric indices were measured at the beginning and the end of the trial. At the end of the 6 month evaluation period, plasma levels of albumin, phosphorus, K, calcium, and bicarbonate showed no significant changes. Body weight and BMI increased significantly in high bicarbonate arm but did not change significantly in the control group. Percent body fat in the arms and legs did not change in intervention arm, but decreased significantly in the controls. The results suggest that higher bicarbonate dialysis can have beneficial effects on nutritional status and might protect against loss of fat mass.
Substances chimiques
Bicarbonates
0
Hemodialysis Solutions
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
317-322Informations de copyright
© 2020 International Society for Hemodialysis.
Références
Basile C, Rossi L, Lomonte C. The choice of dialysate bicarbonate: Do different concentrations make a difference? Kidney Int. 2016;89:1008-1015.
Kraut JA, Kurtz I. Metabolic acidosis of CKD: Diagnosis, clinical characteristics, and treatment. Am J Kidney Dis. 2005;45:978-983.
Chauveau P, Rigothier C, Combe C. Con: Higher serum bicarbonate in dialysis patients is protective. Nephrol Dial Transplant. 2016;31:1226-1229.
Chauveau P, Fouque DP, Combe C, et al. Acidosis and nutritional status in hemodialyzed patients. French Study Group for Nutrition in Dialysis. Semin Dial. 2000;13:241-246.
Lowrie EG, Lew NL. Death risk in hemodialysis patients: The predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis. 1990;15:458-482.
Bommer J, Locatelli F, Satayathum S, et al. Association of predialysis serum bicarbonate levels with risk of mortality and hospitalization in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2004;44:661-671.
Kittiskulnam P, Eiam-Ong S. Body Composition and Its Clinical Outcome in Maintenance Hemodialysis Patients; 2017. https://doi.org/10.5772/intechopen.70353
Fouque DP, Vennegoor M, Weeter P, et al. EBPG guideline on nutrition. Nephrol Dial Transplant. 2007;22:ii45-ii87.
Pupim LB, Caglar K, Hakim RM, Shyr Y, Ikizler TA. Uremic malnutrition is a predictor of death independent of inlammatory status. Kidney Int. 2004;66:2054-2060.
Carrero JJ, Stenvinkel P, Cuppari L, et al. Etiology of the protein-energy wasting syndrome in chronic kidney disease: A consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr. 2013;23:77-90.
Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391-398.
Kakiya R, Shoji T, Tsujimoto Y, et al. Body fat mass and lean mass as predictors of survival in hemodialysis patients. Kidney Int. 2006;70:549-556.
Kalantar-Zadeh K, Kuwae N, Wu DY, et al. Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients. Am J Clin Nutr. 2006;83:202-210.
Franch HA, Mitch WE. Catabolism in uremia: The impact of metabolic acidosis. J Am Soc Nephrol. 1998;9:S78-S81.
Kalantar-Zadeh K, Mehrotra R, Fouque D, Kopple JD. Metabolic acidosis and malnutrition-inflammation complex syndrome in chronic renal failure. Semin Dial. 2004;17:445-465.
Uribarri J, Levin NW, Delmez J, et al. Association of acidosis and nutritional parameters in hemodialysis patients. Am J Kidney Dis. 1999;34:493-499.
Kopple JD, Kalantar-Zadeh K, Mehrotra R. Risks of chronic metabolic acidosis in patients with chronic kidney disease. Kidney Int Suppl. 2005;95:S21-S27.
Chang TI, Oh HJ, Kang EW, et al. A low serum bicarbonate concentration as a risk factor for mortality in peritoneal dialysis patients. PLoS One. 2013;8:e82912.
Wang J, Streja E, Rhee CM, et al. Lean body mass and survival in hemodialysis patients and the roles of race and ethnicity. J Ren Nutr. 2016 January;26:26-37.
Sarkar SR, Kuhlmann MK, Kotanko P, et al. Metabolic consequences of body size and body composition in hemodialysis patients. Kidney Int. 2006;70:1832-1839.
Aparicio M, Cano N, Chauveau P, et al. Nutritional status of haemodialysis patients: A French national cooperative study. French Study Group for Nutrition in Dialysis. Nephrol Dial Transplant. 1999;14:1679-1686.
Rocco MV, Paranandi L, Burrowes JD, et al. Nutritional status in the HEMO study cohort at baseline. Hemodial Am J Kidney Dis. 2002;39:245-256.
Combe C, Chauveau P, Laville M, et al. Influence of nutritional factors and hemodialysis adequacy on the survival of 1,610 French patients. Am J Kidney Dis. 2001;37:S81-S88.
Dwyer JT, Larive B, Leung J, et al. HEMO Study Group. Are nurtitional status indicators associated with mortality in the hemodialysis (HEMO) study? Kidney Int. 2005;68:1766-1776.
Kalantar-Zadeh K, Supasyndh O, Lehn RS, McAllister CJ, Kopple JD. Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt/V greater than 1.20. J Ren Nutr. 2003;13:15-25.
Noori N, Kovesdy CP, Dukkipati R, et al. Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis. Am J Clin Nutr. 2010;92:1060-1070.
Huang CX, Tighiouart H, Beddhu S, et al. Both low muscle mass and low fat are associated with higher all-cause mortality in hemodialysis patients. Kidney Int. 2010;77:624-629.
Postorino M, Marino C, Tripepi G, Zoccali C. Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. J Am Coll Cardiol. 2009;53:1265-1272.
Marcelli D, Wabel P, Wieskoten S, et al. Physical methods for evaluating the nutrition status of hemodialysis patients. J Nephrol. 2015;28:523-530.
Prado CM, Heymsield SB. Lean tissue imaging: A new era for nutritional assessment and intervention. JPEN. J Parenter Enteral Nutr. 2014;38:940-953.
Frassetto L, Banerjee T, Powe N, Sebastian A. Acid balance, dietary acid load, and bone effects-A controversial subject. Nutrients. 2018;10:517.
Saric T, Graef CI, Goldberg AL. Pathway for degradation of peptides generated by proteasomes: A key role for thimet oligopeptidase and other metallopeptidases. J Biol Chem. 2004;279:46723-46732.
Wang XH, Mitch WE. Mechanisms of muscle wasting in chronic kidney disease. Nat Rev Nephrol. 2014;10:504-516.
Graham KA, Reaich D, Channon SM, Downie S, Goodship TH. Correction of acidosis in hemodialysis decreases whole body protein degradation. J Am Soc Nephrol. 1997;8:632-637.
Williams AJ, Dittmer ID, McArley A, Clarke J. High bicarbonate dialysate in haemodialysis patients: Effects on acidosis and nutritional status. Nephrol Dial Transplant. 1997;12:2633-2637.
Movilli E, Zani R, Carli O, et al. Correction of metabolic acidosis increases serum albumin concentrations and decreases kinetically evaluated protein intake in haemodialysis patients: A prospective study. Nephrol Dial Transplant. 1998;13:1719-1722.
Kern PA, Saghizadeh M, Ong JM, Bosch RJ, Deem R, Simsolo RB. The expression of tumor necrosis factor in human adipose tissue. Regulation by obesity, weight loss, and relationship to lipoprotein lipase. J Clin Invest. 1995;95:2111-2119.
Bertin E, Nguyen P, Guenounou M, et al. Plasma levels of tumor necrosis factor-alpha (TNF-α) are essentially dependent on visceral fat amount in type 2 diabetic patients. Diabetes Metabol. 2000;26:178-182.
Yajima T, Arao M, Yajima K, Takahashi H, Yasuda K. The associations of fat tissue and muscle mass indices with all-cause mortality in patients undergoing hemodialysis. PLoS One. 2019;14:e0211988. https://doi.org/10.1371/journal.pone.0211988.