PMID- 30293714
OWN - NLM
STAT- MEDLINE
DCOM- 20191010
LR  - 20210524
IS  - 2013-2514 (Electronic)
IS  - 2013-2514 (Linking)
VI  - 38
IP  - 6
DP  - 2018 Nov-Dec
TI  - Influence of dietary protein intake on body composition in chronic kidney disease 
      patients in stages 3-5: A cross-sectional study.
PG  - 647-654
LID - S0211-6995(18)30116-4 [pii]
LID - 10.1016/j.nefro.2018.06.007 [doi]
AB  - INTRODUCTION: A controlled protein intake has shown beneficial effects to 
      preserve renal function and nutritional status in chronic kidney disease (CKD) 
      patients. This study aimed to analyze usual dietary protein intake and its 
      potential contribution to body composition in CKD patients in stages 3-5. METHOD: 
      Cross-sectional study in 134 CKD patients in stages 3-5 (mean e-GFR: 
      19.4+/-8.7ml/min/1.73m(2); males 68.7% and primary CKD etiology was diabetes 
      mellitus, 35.8%). Demographic, clinical and nutritional parameters were 
      evaluated. Normalized protein nitrogen appearance (nPNA), was used as a surrogate 
      marker of dietary protein intake. The sample was classified into three nPNA 
      groups (G(n)): G(1): <0.8g/kg/day; G(2): 0.8-1g/kg/day and, G(3): >/=1g/kg/day. 
      Assessment of nutritional status using the malnutrition-inflammation score (MIS), 
      anthropometric measures and laboratory parameters. Analysis of body composition 
      and hydration status by bioelectrical impedance analysis (BIVA-101-RJL system). 
      Statistical analysis by SPSS v.20. RESULTS: Overall mean nPNA values were 
      0.91+/-0.23g of protein/kg BW/day and only 32.1% had a dietary protein intake <0.8g 
      of protein/kg BW/day. Most of the CKD patients (65.5%) were in stages 4 or 5. 
      Prevalence of protein-energy-wasting (PEW) syndrome measured by MIS was 15%. By 
      analyzing differences between nPNA groups, body weight (BW), BMI and 
      triceps-skinfold (TSF) thickness were significantly higher in the group with nPNA 
      >/=1g/kg BW/day (G(3)), whereas a significant inverse relationship was found with 
      the percentages of body cell mass (BCM%), fat-free mass (FFM%), muscle mass (MM%) 
      and phase angle (PA) in the group with the lowest nPNA (G(1)). Analysis of gender 
      among subjects showed significant differences with BW, FFM%, TSF and mid-arm 
      muscle circumference (MAMC%). Linear regression analysis showed that resistance, 
      BCM%, MM%, and serum albumin were significant predictors of nPNA as a surrogate 
      marker of daily protein intake (R=0.51; R(2)=0.29; R(2) adjusted=0.23; p<0.001). 
      CONCLUSION: Controlled protein intake is one of the cornerstones of treatment in 
      CKD patients. A low protein intake in patients with CKD stages 3 and 4-5 was 
      associated with loss of muscle mass in the advanced-CKD unit. The loss of muscle 
      mass appears as an early indicator of nutritional comprised. Factors such, 
      elderly age and loss of eGFR, showed lower protein intake and were associated 
      with muscle loss, especially in women. Further longitudinal studies are required 
      to evaluate the contribution of different protein intakes to uremic symptoms, 
      nutritional status, body composition and CKD progression.
CI  - Copyright (c) 2018 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, 
      S.L.U. All rights reserved.
FAU - Barril, Guillermina
AU  - Barril G
AD  - Department of Nephrology, Advanced-chronic Kidney Disease Unit, Hospital 
      Universitario de la Princesa, C/ Diego de Leon n degrees  62, 28006 Madrid, Spain. 
      Electronic address: gbarril43@gmail.com.
FAU - Nogueira, Angel
AU  - Nogueira A
AD  - Advanced-chronic Kidney Disease Unit, Hospital Universitario de la Princesa, C/ 
      Diego de Leon n degrees  62, 28006 Madrid, Spain.
FAU - Ruperto Lopez, Mar
AU  - Ruperto Lopez M
AD  - Human Nutrition and Dietetics Department, Faculty of Health Sciences, Universidad 
      Alfonso X el Sabio, Avda. Universidad s/n, 28691 Villanueva de la Canada, Madrid, 
      Spain.
FAU - Castro, Yone
AU  - Castro Y
AD  - Orientation Department, Area of Investigation, Prodis Foundation, C/ Bulevar 
      Indalecio Prieto 2, 28032 Madrid, Spain.
FAU - Sanchez-Tomero, Jose Antonio
AU  - Sanchez-Tomero JA
AD  - Department of Nephrology, Advanced-chronic Kidney Disease Unit, Hospital 
      Universitario de la Princesa, 28006 Madrid, Spain.
LA  - eng
LA  - spa
PT  - Journal Article
DEP - 20181004
PL  - Spain
TA  - Nefrologia (Engl Ed)
JT  - Nefrologia
JID - 101778581
RN  - 0 (Dietary Proteins)
SB  - IM
MH  - Aged
MH  - *Body Composition
MH  - Cross-Sectional Studies
MH  - *Dietary Proteins
MH  - Female
MH  - Humans
MH  - Kidney Failure, Chronic
MH  - Male
MH  - Renal Insufficiency, Chronic/*metabolism
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Aparicion de nitrogeno proteico normalizado
OT  - Bioelectrical impedance
OT  - Body composition
OT  - Chronic kidney disease
OT  - Composicion corporal
OT  - Enfermedad renal cronica
OT  - Impedancia bioelectrica
OT  - Ingesta de proteinas
OT  - Masa muscular
OT  - Muscle mass
OT  - Normalized protein nitrogen appearance
OT  - Protein intake
OT  - Protein-energy wasting
OT  - Perdida de energia proteica
EDAT- 2018/10/09 06:00
MHDA- 2019/10/11 06:00
CRDT- 2018/10/09 06:00
PHST- 2017/12/23 00:00 [received]
PHST- 2018/06/01 00:00 [revised]
PHST- 2018/06/07 00:00 [accepted]
PHST- 2018/10/09 06:00 [pubmed]
PHST- 2019/10/11 06:00 [medline]
PHST- 2018/10/09 06:00 [entrez]
AID - S0211-6995(18)30116-4 [pii]
AID - 10.1016/j.nefro.2018.06.007 [doi]
PST - ppublish
SO  - Nefrologia (Engl Ed). 2018 Nov-Dec;38(6):647-654. doi: 
      10.1016/j.nefro.2018.06.007. Epub 2018 Oct 4.