P1579PREVALENCE OF PROTEIN-ENERGY WASTING IN HEMODIALYSIS PATIENTS IN THE EUROPEAN REGION OF THE RUSSIAN FEDERATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alexander Jakovenko ◽  
Aleksander Rumyantsev
Keyword(s):  
Russian Federation ◽  
Survival Rates ◽  
Hemodialysis Patients ◽  
European Region ◽  
Calorie Intake ◽  
Bromocresol Green ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
The Russian Federation ◽  
And Gender

Abstract Background and Aims One of the complications of hemodialysis therapy (HD) is the development of protein-energy wasting (PEW), which is an independent predictor of morbidity and mortality in this cohort of patients. The prevalence of PEW in hemodialysis patients in different regions of the world varies from 15% to 75% but has not been practically studied in the Russian Federation. To assess the prevalence of protein-energy wasting in hemodialysis patients in the European region of the Russian Federation. Method 645 hemodialysis patients were examined in 9 hemodialysis centers in 5 regions of the European part of the Russian Federation. Among the patients there were 345 women and 300 men, the average age was 56.8 ± 12.8 years. The duration of hemodialysis therapy was 8.4 ± 5.3 years. The diagnosis of PEW was established in accordance with the criteria: biochemical criteria (serum albumin < 3.8 g per 100 ml; serum prealbumin (transthyretin) < 30 mg per 100 ml; serum cholesterol < 100 mg per 100 ml); low body weight, reduced total body fat, or weight loss; a decrease in muscle mass; and low protein or energy intakes. The level of blood albumin was determined using the BCG method (bromocresol green). Estimation of protein and calorie intake was performed using 3-day food diaries filled out by patients. Results Insufficient protein intake according to the International Society of Renal Nutrition and Metabolism (ISRNM) recommendations was observed in 5.5 % of patients, calories in 4.1 %, combined deficiency in protein and calorie intake in 2.7% of patients. The prevalence of PEW was 51.2 %. The relationship between age and gender was not identified. The lowest prevalence of PEW is observed in patients with a hemodialysis therapy experience of fewer than 5 years (25,4 %) and gradually increasing by 2.5 times in patients with survival rates on HD for more than 10 years (χ2 = 22,580 р = 0.0001). Conclusion The prevalence of protein-energy wasting in hemodialysis patients in the European region of the Russian Federation is 51,2 %.

scholarly journals Hemodialysis—Nutritional Flaws in Diagnosis and Prescriptions. Could Amino Acid Losses Be the Sharpest “Sword of Damocles”?

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1773 ◽  
Author(s):  
Piergiorgio Bolasco
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Hemodialysis Patients ◽  
Calorie Intake ◽  
Protein Energy Wasting ◽  
Slowing Down ◽  
Protein Energy ◽  
Determining Factor ◽  
Over Time

This review aims to highlight the strengths and weaknesses emerging from diagnostic evaluations and prescriptions in an intent to prevent progression over time of malnutrition and/or protein-energy wasting (PEW) in hemodialysis (HD) patients. In particular, indications of the most effective pathway to follow in diagnosing a state of malnutrition are provided based on a range of appropriate chemical-clinical, anthropometric and instrumental analyses and monitoring of the nutritional status of HD patients. Finally, based on the findings of recent studies, therapeutic options to be adopted for the purpose of preventing or slowing down malnutrition have been reviewed, with particular focus on protein-calorie intake, the role of oral and/or intravenous supplements and efficacy of some classes of amino acids. A new determining factor that may lead inexorably to PEW in hemodialysis patients is represented by severe amino acid loss during hemodialysis sessions, for which mandatory compensation should be introduced.

scholarly journals CARBON CHARGE IN THE ENVIRONMENTAL CUSTOMS PAYMENT SYSTEM: INNOVATION OF THE ECONOMIC ENVIRONMENTAL PROTECTION MECHANISM

2021 ◽  
Vol 6 (11(61)) ◽  
pp. 72-77
Author(s):  
Nina A. Ronzhina ◽  
Alexander D. Gorokhov
Keyword(s):  
Environmental Protection ◽  
Russian Federation ◽  
Payment System ◽  
Environmental Efficiency ◽  
Economic Consequences ◽  
System Innovation ◽  
European Region ◽  
Protection Mechanism ◽  
Economic Mechanism ◽  
The Russian Federation

The article discusses topical innovations in the development of the current economic mechanism for environmental protection. The issues of introducing into the system of environmental customs fees of carbon payments to import «climate unfavorable» goods, its environmental efficiency is analyzed, as well as economic consequences from the inclusion of payment into the system of customs fees of the European Region. In the specified context, the authors consider problems and prospects for the implementation of such environmental payments into the system of national law of the Russian Federation.

Association of subjective global assessment of nutritional status with gut microbiota in hemodialysis patients: a case–control study

2020 ◽  
Author(s):  
Ting-Yun Lin ◽  
Szu-Chun Hung
Keyword(s):  
Nutritional Status ◽  
Gut Microbiota ◽  
Global Assessment ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Subjective Global Assessment ◽  
Protein Energy Wasting ◽  
Β Diversity ◽  
Protein Energy ◽  
Α Diversity

Abstract Background Protein-energy wasting (PEW) is prevalent and associated with adverse outcomes in patients with chronic kidney disease (CKD). However, the pathogenesis of PEW in CKD patients has not been fully identified. The gut microbiota has been implicated in the regulation of host metabolism and energy balance. Therefore, we aimed to explore the association between nutritional status and the composition of the gut microbiota in hemodialysis patients. Methods Gut microbial diversity and taxonomy were examined in 88 hemodialysis patients with PEW (n = 22) and normal nutritional status (n = 66) who were matched 1:3 for age and sex. Nutritional status was assessed by using the 7-point subjective global assessment (SGA) score (1–3 = severe PEW; 4–5 = moderate PEW and 6–7 = normal nutrition). The gut microbiota was assessed by 16S ribosomal RNA gene sequencing. Results Patients with normal nutritional status had a significantly higher body mass index and physical activity and serum albumin levels, but significantly lower levels of inflammatory cytokines than patients with PEW. The most striking finding was that the α-diversity of the gut microbiota was significantly lower in patients with PEW. In a multivariate analysis, the SGA score was independently and positively associated with α-diversity (P = 0.049). Patients with or without PEW were different with respect to the principal coordinate analysis of β-diversity. Notably, the relative abundance of Faecalibacterium prausnitzii, a butyrate-producing bacteria, was markedly reduced in patients with PEW. Conclusion In hemodialysis patients, PEW assessed with the SGA was associated with gut dysbiosis.

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