Journal of Renal Nutrition
Volume 19, Issue 4 , Pages 291-297 , July 2009

Severity of Hypoalbuminemia Predicts Response to Intradialytic Parenteral Nutrition in Hemodialysis Patients

  • Arezu Dezfuli, MD

      Affiliations

    • Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center, Torrance, California
    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center, Torrance, California
  • ,
  • Deborah Scholl, MS, RD

      Affiliations

    • Pentec Health, Boothwyn, Pennsylvania
  • ,
  • Stanley M. Lindenfeld, MD

      Affiliations

    • Pentec Health, Boothwyn, Pennsylvania
  • ,
  • Csaba P. Kovesdy, MD

      Affiliations

    • Division of Nephrology, Salem Veterans Administration Medical Center, Salem, Virginia
  • ,
  • Kamyar Kalantar-Zadeh, MD, MPH, PhD

      Affiliations

    • Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center, Torrance, California
    • Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center, Torrance, California
    • Pentec Health, Boothwyn, Pennsylvania
    • Corresponding Author InformationAddress reprint requests to Kamyar Kalantar-Zadeh, MD, MPH, PhD, Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center, 1124 West Carson St., C1-Annex, Torrance, CA 90502.

References 

  1. United States Renal Data System . United States Renal Data System 2006 annual data report. Atlas of chronic kidney disease and end-stage renal disease in the United States. Am J Kidney Dis. 2007;49:1–296
  2. Wanner C, Krane V, Marz W, et al. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005;353:238–248
  3. Kilpatrick RD, McAllister CJ, Kovesdy CP, Derose SF, Kopple JD, Kalantar-Zadeh K. Association between serum lipids and survival in hemodialysis patients and impact of race. J Am Soc Nephrol. 2007;18:293–303
  4. Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, Greenland S, Kopple JD. Reverse epidemiology of hypertension and cardiovascular death in the hemodialysis population: the 58th Annual Fall Conference and Scientific Sessions. Hypertension. 2005;45:811–817
  5. Kalantar-Zadeh K, Kilpatrick RD, Kuwae N, et al. Revisiting mortality predictability of serum albumin in the dialysis population: time dependency, longitudinal changes and population-attributable fraction. Nephrol Dial Transplant. 2005;20:1880–1888
  6. Shinaberger CS, Kilpatrick RD, Regidor DL, et al. Longitudinal associations between dietary protein intake and survival in hemodialysis patients. Am J Kidney Dis. 2006;48:37–49
  7. Kalantar-Zadeh K, Kopple JD, Kilpatrick RD, et al. Association of morbid obesity and weight change over time with cardiovascular survival in hemodialysis population. Am J Kidney Dis. 2005;46:489–500
  8. 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
  9. Pupim LB, Ikizler TA. Uremic malnutrition: new insights into an old problem. Semin Dial. 2003;16:224–232
  10. Kalantar-Zadeh K, Balakrishnan VS. The kidney disease wasting: inflammation, oxidative stress, and diet-gene interaction. Hemodial Int. 2006;10:315–325
  11. Kalantar-Zadeh K. Recent advances in understanding the malnutrition-inflammation-cachexia syndrome in chronic kidney disease patients: what is next?. Semin Dial. 2005;18:365–369
  12. National Kidney Foundation . Kidney Disease-Dialysis Outcome Quality Initiative, K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2000;35(Suppl):S1–S140
  13. Kovesdy CP, Kalantar-Zadeh K. Novel targets and new potential: developments in the treatment of inflammation in chronic kidney disease. Expert Opin Invest Drugs. 2008;17:451–467
  14. Pupim LB, Caglar K, Hakim RM, Shyr Y, Ikizler TA. Uremic malnutrition is a predictor of death independent of inflammatory status. Kidney Int. 2004;66:2054–2060
  15. Lacson E, Ikizler TA, Lazarus JM, Teng M, Hakim RM. Potential impact of nutritional intervention on end-stage renal disease hospitalization, death, and treatment costs. J Ren Nutr. 2007;17:363–371
  16. Cano NJ, Leverve XM. Intradialytic nutritional support. Curr Opin Clin Nutr Metab Care. 2008;11:147–151
  17. Pupim LB, Majchrzak KM, Flakoll PJ, Ikizler TA. Intradialytic oral nutrition improves protein homeostasis in chronic hemodialysis patients with deranged nutritional status. J Am Soc Nephrol. 2006;17:3149–3157
  18. Durrleman S, Simon R. Flexible regression models with cubic splines. Stat Med. 1989;8:551–561
  19. Kovesdy CP, Trivedi BK, Anderson JE. Association of kidney function with mortality in patients with chronic kidney disease not yet on dialysis: a historical prospective cohort study. Adv Chron Kidney Dis. 2006;13:183–188
  20. Kalantar-Zadeh K, Kovesdy CP, Derose SF, Horwich TB, Fonarow GC. Racial and survival paradoxes in chronic kidney disease. Nat Clin Pract Nephrol. 2007;3:493–506
  21. Kalantar-Zadeh K, Abbott KC, Kronenberg F, Anker SD, Horwich TB, Fonarow GC. Epidemiology of dialysis patients and heart failure patients. Semin Nephrol. 2006;26:118–133
  22. Kovesdy CP, Kalantar-Zadeh K. Why is protein-energy wasting associated with mortality in chronic kidney disease?. Semin Nephrol. 2009;29:3–14
  23. Kalantar-Zadeh K, Abbott KC, Salahudeen AK, Kilpatrick RD, Horwich TB. Survival advantages of obesity in dialysis patients. Am J Clin Nutr. 2005;81:543–554
  24. Kalantar-Zadeh K. What is so bad about reverse epidemiology anyway?. Semin Dial. 2007;20:593–601
  25. Chertow GM, Ling J, Lew NL, Lazarus JM, Lowrie EG. The association of intradialytic parenteral nutrition administration with survival in hemodialysis patients. Am J Kidney Dis. 1994;24:912–920
  26. Capelli JP, Kushner H, Camiscioli TC, Chen SM, Torres MA. Effect of intradialytic parenteral nutrition on mortality rates in end-stage renal disease care. Am J Kidney Dis. 1994;23:808–816
  27. Korzets A, Azoulay O, Ori Y, et al. The use of intradialytic parenteral nutrition in acutely ill haemodialysed patients. J Ren Care. 2008;34:14–18
  28. Cano NJ, Fouque D, Roth H, et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J Am Soc Nephrol. 2007;18:2583–2591

 This study was supported by a philanthropic grant from Mr. Harold Simmons.

 This study was presented in part at the Spring Clinical Conference of the National Kidney Foundation, April 4–8, 2008, Dallas, Texas.

 Potential conflict of interest: D.S. and S.M.L. have been employees and/or executives of Pentec Health, the provider of the intradialytic parenteral nutrition that was used in this study.

PII: S1051-2276(09)00045-4

doi: 10.1053/j.jrn.2009.01.023

Journal of Renal Nutrition
Volume 19, Issue 4 , Pages 291-297 , July 2009