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Article: Energy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion

TitleEnergy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion
Authors
Issue Date2009
Citation
American Journal of Clinical Nutrition, 2009, v. 90, n. 5, p. 1179-1184 How to Cite?
AbstractBackground: Circulatory congestion is an adverse predictor of mortality in peritoneal dialysis (PD) patients. Objective: This study evaluated the nutritional status, energy intake, and expenditure profile of PD patients with and without previous circulatory congestion. Design: We conducted a cross-sectional study in 244 PD patients, of whom 92 had previous circulatory congestion. We estimated dietary energy intake by using a locally validated 7-d food-frequency questionnaire and by assessing resting energy expenditure (REE) and total energy expenditure (TEE) with indirect calorimetry and a locally validated physical activity questionnaire, respectively. Results: In comparison with those without circulatory congestion, patients with previous circulatory congestion were more malnourished by subjective global assessment (59% compared with 36%; P < 0.001), had lower handgrip strength, had lower midarm muscle circumference, had lower dietary protein (0.98 ± 0.45 compared with 1.19 ± 0.44 g · kg-1 · d-1; P < 0.001), and had lower energy intake (92.5 ± 37.0 compared with 110.9 ± 35.7 kJ · kg-1 · d-1; P < 0.001) but had higher C-reactive protein (P = 0.025) and higher REE (P < 0.001). However, no difference in TEE was noted between the 2 groups, which indicated lower activity energy expenditure among patients with previous circulatory congestion. The resulting energy balance was significantly more negative for patients with previous circulatory congestion than for those without previous circulatory congestion (P = 0.050). Furthermore, the prevalence of malnutrition increased with increasing episodes of circulatory congestion (P = 0.017). Conclusions: Patients with previous circulatory congestion had significantly more inflammation, more muscle wasting, and higher REE but lower activity energy expenditure and energy and protein intakes in keeping with an anorexia-cachexia syndrome. The mechanisms of increased REE and reduced energy intake among patients with previous circulatory congestion warrant further investigation. © 2009 American Society for Nutrition.
Persistent Identifierhttp://hdl.handle.net/10722/228458
ISSN
2015 Impact Factor: 6.703
2015 SCImago Journal Rankings: 3.771

 

DC FieldValueLanguage
dc.contributor.authorWang, Angela Yee Moon-
dc.contributor.authorSea, Mandy Man Mei-
dc.contributor.authorTang, Nelson-
dc.contributor.authorLam, Christopher Wai Kei-
dc.contributor.authorChan, Iris Hiu Shuen-
dc.contributor.authorLui, Siu Fai-
dc.contributor.authorSanderson, John E.-
dc.contributor.authorWoo, Jean-
dc.date.accessioned2016-08-13T08:02:28Z-
dc.date.available2016-08-13T08:02:28Z-
dc.date.issued2009-
dc.identifier.citationAmerican Journal of Clinical Nutrition, 2009, v. 90, n. 5, p. 1179-1184-
dc.identifier.issn0002-9165-
dc.identifier.urihttp://hdl.handle.net/10722/228458-
dc.description.abstractBackground: Circulatory congestion is an adverse predictor of mortality in peritoneal dialysis (PD) patients. Objective: This study evaluated the nutritional status, energy intake, and expenditure profile of PD patients with and without previous circulatory congestion. Design: We conducted a cross-sectional study in 244 PD patients, of whom 92 had previous circulatory congestion. We estimated dietary energy intake by using a locally validated 7-d food-frequency questionnaire and by assessing resting energy expenditure (REE) and total energy expenditure (TEE) with indirect calorimetry and a locally validated physical activity questionnaire, respectively. Results: In comparison with those without circulatory congestion, patients with previous circulatory congestion were more malnourished by subjective global assessment (59% compared with 36%; P < 0.001), had lower handgrip strength, had lower midarm muscle circumference, had lower dietary protein (0.98 ± 0.45 compared with 1.19 ± 0.44 g · kg-1 · d-1; P < 0.001), and had lower energy intake (92.5 ± 37.0 compared with 110.9 ± 35.7 kJ · kg-1 · d-1; P < 0.001) but had higher C-reactive protein (P = 0.025) and higher REE (P < 0.001). However, no difference in TEE was noted between the 2 groups, which indicated lower activity energy expenditure among patients with previous circulatory congestion. The resulting energy balance was significantly more negative for patients with previous circulatory congestion than for those without previous circulatory congestion (P = 0.050). Furthermore, the prevalence of malnutrition increased with increasing episodes of circulatory congestion (P = 0.017). Conclusions: Patients with previous circulatory congestion had significantly more inflammation, more muscle wasting, and higher REE but lower activity energy expenditure and energy and protein intakes in keeping with an anorexia-cachexia syndrome. The mechanisms of increased REE and reduced energy intake among patients with previous circulatory congestion warrant further investigation. © 2009 American Society for Nutrition.-
dc.languageeng-
dc.relation.ispartofAmerican Journal of Clinical Nutrition-
dc.titleEnergy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.3945/ajcn.2009.28160-
dc.identifier.pmid19776138-
dc.identifier.scopuseid_2-s2.0-70350651579-
dc.identifier.volume90-
dc.identifier.issue5-
dc.identifier.spage1179-
dc.identifier.epage1184-

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