Tasa de catabolismo proteico normalizado (nPCR) y fragilidad en pacientes en hemodiálisis
DOI:
https://doi.org/10.12873/442arteagaPalabras clave:
Hemodiálisis, Tasa de catabolismo proteico normalizado, FragilidadResumen
Introducción: La ingesta de proteínas insuficiente y la fragilidad son problemáticas frecuentes en pacientes en hemodiálisis (HD). Objetivo: El objetivo de este estudio fue determinar la asociación entre la tasa de catabolismo proteico normalizado (nPCR) y la fragilidad en pacientes en HD ambulatoria. Pacientes y Métodos: Estudio transversal, realizado en el Instituto del Riñón y Diálisis “INRIDI San Martín” de Guayaquil, Ecuador. Se utilizó el nPCR como indicador indirecto de la ingesta de proteínas y se clasificó como: <1 g/kg/día (bajo), 1-1,2 g/kg/día (medio) y >1,2 g/kg/día (alto); la fragilidad se valoró con la escala FRAIL. Resultados: Se evaluó a 49 participantes con una edad de 58 (52,5-65,5) años, el 65,3% (n=32) eran mujeres, la media de IMC fue 27,4 ± 4,9 kg/m2 y el nPCR de 0,80 (0,67-0,93) g/kg/día. El 85,7% (n=42) presentó un nPCR bajo y 42,9% (n=22) tuvo fragilidad. No se encontró asociación entre el nPCR y la fragilidad en los sujetos estudiados (p=0,828). Conclusión: No existe asociación entre nPCR y fragilidad en la población estudiada.
Citas
Proietti M, Cesari M. Frailty: What Is It? Adv Exp Med Biol. 2020;1216:1-7. Doi: 10.1007/978-3-030-33330-0_1
Daya N, Voskertchian A, Schneider ALC, Ballew S, McAdams DeMarco M, Coresh J, et al. Kidney Function and Fracture Risk: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis. 2016;67(2):218-26. Doi: 10.1053/j.ajkd.2015.06.020
Lee HJ, Son YJ. Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(7):3471. Doi: 10.3390/ijerph18073471
Garcia-Canton C, Rodenas A, Lopez-Aperador C, Rivero Y, Anton G, Monzon T, et al. Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services. Ren Fail. 2019;41(1):567-75. Doi: 10.1080/0886022X.2019.1628061
Wu PY, Chao CT, Chan DC, Huang JW, Hung KY. Contributors, risk associates, and complications of frailty in patients with chronic kidney disease: a scoping review. Ther Adv Chronic Dis. 2019;10:2040622319880382. Doi: 10.1177/2040622319880382
Hendra H, Sridharan S, Farrington K, Davenport A. Characteristics of Frailty in Haemodialysis Patients. Gerontol Geriatr Med. 2022;8:23337214221098889. Doi: 10.1177/23337214221098889
Wong L, Duque G, McMahon LP. Sarcopenia and Frailty: Challenges in Mainstream Nephrology Practice. Kidney Int Rep. 2021;6(10):2554-64. Doi: 10.1016/j.ekir.2021.05.039
Otobe Y, Rhee CM, Nguyen M, Kalantar-Zadeh K, Kopple JD. Current Status of the Assessment of Sarcopenia, Frailty, Physical Performance and Functional Status in Chronic Kidney Disease Patients. Curr Opin Nephrol Hypertens. 2022;31(1):109-28. Doi: 10.1097/MNH.0000000000000763
Chao CT, Lin SH. Uremic Toxins and Frailty in Patients with Chronic Kidney Disease: A Molecular Insight. Int J Mol Sci. 2021;22(12):6270. Doi: 10.3390/ijms22126270
Song YH, Cai GY, Xiao YF, Chen XM. Risk factors for mortality in elderly haemodialysis patients: a systematic review and meta-analysis. BMC Nephrology. 2020;21(1):377. Doi: 10.1186/s12882-020-02026-x
Saglimbene VM, Su G, Wong G, Natale P, Ruospo M, Palmer SC, et al. Dietary intake in adults on hemodialysis compared with guideline recommendations. J Nephrol. 2021;34(6):1999-2007. Doi: 10.1007/s40620-020-00962-3
Liu PJ, Ma F, Wang QY, He SL. The effects of oral nutritional supplements in patients with maintenance dialysis therapy: A systematic review and meta-analysis of randomized clinical trials. PLoS One. 2018;13(9):e0203706. Doi: 10.1371/journal.pone.0203706
Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. American Journal of Kidney Diseases. 2020;76(3):S1-107. Doi: 10.1053/j.ajkd.2020.05.006
Hendriks FK, Smeets JSJ, van der Sande FM, Kooman JP, van Loon LJC. Dietary Protein and Physical Activity Interventions to Support Muscle Maintenance in End-Stage Renal Disease Patients on Hemodialysis. Nutrients. 2019;11(12):2972. Doi: 10.1053/j.ajkd.2020.05.006
Sahathevan S, Karupaiah T, Khor BH, Sadu Singh BK, Mat Daud ZA, Fiaccadori E, et al. Muscle Status Response to Oral Nutritional Supplementation in Hemodialysis Patients With Protein Energy Wasting: A Multi-Center Randomized, Open Label-Controlled Trial. Front Nutr. 2021;8:743324. Doi: 10.3389/fnut.2021.743324
Hara H, Nakamura Y, Hatano M, Iwashita T, Shimizu T, Ogawa T, et al. Protein Energy Wasting and Sarcopenia in Dialysis Patients. Recent Advances in Dialysis Therapy in Japan. 2018;196:243-9. Doi: 10.1159/000485729
Coelho-Junior HJ, Calvani R, Picca A, Tosato M, Landi F, Marzetti E. Protein Intake and Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2022;14(13):2767. Doi: 10.3390/nu14132767
Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty Consensus: A Call to Action. J Am Med Dir Assoc. 2013;14(6):392-7. Doi: 10.1016/j.jamda.2013.03.022.
Depner TA, Daugirdas JT. Equations for normalized protein catabolic rate based on two-point modeling of hemodialysis urea kinetics. J Am Soc Nephrol. 1996;7(5):780-5. Doi: 10.1681/ASN.V75780.
Shrestha B, Dunn L. The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision. J Nepal Health Res Counc. 2020;17(4):548-52. Doi: 10.33314/jnhrc.v17i4.1042.
Hasegawa J, Kimachi M, Kurita N, Kanda E, Wakai S, Nitta K. The Normalized Protein Catabolic Rate and Mortality Risk of Patients on Hemodialysis by Frailty Status: The Japanese Dialysis Outcomes and Practice Pattern Study. J Ren Nutr. 2020;30(6):535-9. Doi: 10.1053/j.jrn.2019.12.005.
Zheng CM, Hsu YH, Lu CL, Chen HH, Lu KC, Chen JS, et al. The modulating effect of dietary protein intake on mortality in long-term hemodialysis patients: A nationwide population-based study. International Journal of Clinical Practice. 2021;75(3):e13747. Doi: 10.1111/ijcp.13747.
Wadhwa A, Balbale SN, Palleti SK, Samra M, Lopez-Soler RI, Stroupe KT, et al. Prevalence and feasibility of assessing the frailty phenotype among hemodialysis patients in a dialysis unit. BMC Nephrol. 2023;24(1):371. Doi: 10.1186/s12882-023-03413-w
Lee HJ, Son YJ. Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(7):3471. Doi: 10.3390/ijerph18073471.
Caldiroli L, Molinari P, Dozio E, Rigolini R, Giubbilini P, Romanelli MMC, et al. In Patients with Chronic Kidney Disease Advanced Glycation End-Products Receptors Isoforms (sRAGE and esRAGE) Are Associated with Malnutrition. Antioxidants (Basel). 2022;11(7):1253. Doi: 10.3390/antiox11071253.
Ohnaka S, Yamada S, Tsujikawa H, Arase H, Taniguchi M, Tokumoto M, et al. Association of normalized protein catabolic rate (nPCR) with the risk of bone fracture in patients undergoing maintenance hemodialysis: The Q-Cohort Study. Clin Nutr. 2021;40(3):997-1004. Doi: 10.1016/j.clnu.2020.07.003
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