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

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSILVA, Luana Cristina A. de
dc.contributor.authorCORREIA, Marilia A. de
dc.contributor.authorGOUVEIA, Renata Daniel
dc.contributor.authorSOUZA, Mayara S.
dc.contributor.authorJR, Carlos P. Isaac
dc.contributor.authorPARRILLO, Fernando
dc.contributor.authorMOYSES, Rosa M. A.
dc.contributor.authorDALBONI, Maria Aparecida
dc.contributor.authorELIAS, Rosilene M.
dc.date.accessioned2023-12-15T19:02:42Z
dc.date.available2023-12-15T19:02:42Z
dc.date.issued2023
dc.description.abstractBackground & 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.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationCLINICAL NUTRITION ESPEN, v.58, p.97-103, 2023
dc.identifier.doi10.1016/j.clnesp.2023.09.006
dc.identifier.issn2405-4577
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/57702
dc.language.isoeng
dc.publisherELSEVIEReng
dc.relation.ispartofClinical Nutrition Espen
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIEReng
dc.subjectMalnutritioneng
dc.subjectDialysiseng
dc.subjectBioimpedanceeng
dc.subjectEnd-stage renal diseaseeng
dc.subjectMortalityeng
dc.subject.otherchronic kidney-diseaseeng
dc.subject.otherhemodialysis-patientseng
dc.subject.othermortalityeng
dc.subject.othersarcopeniaeng
dc.subject.othercohorteng
dc.subject.wosNutrition & Dieteticseng
dc.titleEffects of nutritional supplementation stabilizing muscle mass loss in older patients on hemodiafiltrationeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalSILVA, Luana Cristina A. de:Univ Nove Julho UNINOVE, Sao Paulo, SP, Brazil; Hosp Sancta Maggiore, Sao Paulo, SP, Brazil
hcfmusp.author.externalCORREIA, Marilia A. de:Univ Nove Julho UNINOVE, Sao Paulo, SP, Brazil
hcfmusp.author.externalGOUVEIA, Renata Daniel:Hosp Sancta Maggiore, Sao Paulo, SP, Brazil
hcfmusp.author.externalSOUZA, Mayara S.:Hosp Sancta Maggiore, Sao Paulo, SP, Brazil
hcfmusp.author.externalJR, Carlos P. Isaac:Hosp Sancta Maggiore, Sao Paulo, SP, Brazil
hcfmusp.author.externalPARRILLO, Fernando:Hosp Sancta Maggiore, Sao Paulo, SP, Brazil
hcfmusp.author.externalDALBONI, Maria Aparecida:Univ Nove Julho UNINOVE, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcROSA MARIA AFFONSO MOYSES
hcfmusp.contributor.author-fmusphcROSILENE MOTTA ELIAS
hcfmusp.description.beginpage97
hcfmusp.description.endpage103
hcfmusp.description.volume58
hcfmusp.origemWOS
hcfmusp.origem.pubmed38057042
hcfmusp.origem.scopus2-s2.0-85172010272
hcfmusp.origem.wosWOS:001085275400001
hcfmusp.publisher.cityAMSTERDAMeng
hcfmusp.publisher.countryNETHERLANDSeng
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