Effects of nutritional supplementation stabilizing muscle mass loss in older patients on hemodiafiltration

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article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
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ELSEVIER
Autores
SILVA, Luana Cristina A. de
CORREIA, Marilia A. de
GOUVEIA, Renata Daniel
SOUZA, Mayara S.
JR, Carlos P. Isaac
PARRILLO, Fernando
DALBONI, Maria Aparecida
Citação
CLINICAL NUTRITION ESPEN, v.58, p.97-103, 2023
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background & aims: Malnutrition is common in older individuals with end-stage renal disease on maintenance dialysis. Whether nutritional supplementation may improve skeletal muscle mass (SMM) and survival rate in this population is uncertain. We aimed to analyze the effect of a year of nutritional supplementation on muscle mass and survival rate in older patients on hemodiafiltration.Methods: In this observational study, older patient (>= 65 years old) on maintenance hemodiafiltration were selected to receive nutritional counselling + nutritional supplementation (N = 85, Supp+) or nutritional counselling alone (N = 47, Supp-) and followed for 1 year. The outcomes were a change in SMM and sarcopenia diagnosis. The secondary outcome was 1-year mortality rate. Nutritional parameters included calf circumference, body mass index, anthropometric measurements, subjective global assessment, and handgrip strength (HGS). Data were evaluated using GLM for repeated measures with adjustment for covariates (age and diabetes).Results: Malnutrition was found in 50.8% of patients. At baseline, patients from the Supp+ group were older and had worse nutritional parameters including hand grip strength, calf circumference, anthro-pometric findings and sarcopenia (all p values < 0.05). During the follow-up, there was no significant change in sarcopenia (from 50.8% to 58.3%, p = 0.108), and there was a more pronounced decrease in the SMM index in the Supp-group (p = 0.049), with a significant intervention interaction (p = 0.030). Twenty deaths occurred, 7 (35%) in the Supp-and 13 (65%) in the Supp+ group (p = 0.540). SMM index (relative risk 0.90, p = 0.030) and age (relative risk 1.07, p = 0.046) were independently associated with higher mortality rates. Conclusion: Nutritional supplementation in older and malnourished individuals undergoing hemodia-filtration mitigates the loss of the SMM index and benefits survival rate.(c) 2023 European Society for Clinical Nutrition and Metabolism.
Palavras-chave
Malnutrition, Dialysis, Bioimpedance, End-stage renal disease, Mortality
URI
https://observatorio.fm.usp.br/handle/OPI/57702
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/16
Artigos e Materiais de Revistas Científicas - ODS/02
Artigos e Materiais de Revistas Científicas - ODS/03