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Low serum sodium is associated with protein energy wasting and increased interdialytic weight gain in haemodialysis patients.

Poulikakos, D; Marks, V; Lelos, N; Banerjee, D (2014) Low serum sodium is associated with protein energy wasting and increased interdialytic weight gain in haemodialysis patients. Clin Kidney J, 7 (2). pp. 156-160. ISSN 2048-8505 https://doi.org/10.1093/ckj/sft170
SGUL Authors: Banerjee, Debasish

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Abstract

BACKGROUND: Low serum sodium (Na) has been associated with decreased body mass index and increased cardiovascular mortality in haemodialysis (HD) patients. We examined the relationship between serum Na and selected nutritional parameters of protein energy wasting that are not affected from the hydration status in a cohort of HD patients. METHODS: Triceps skinfold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), handgrip strength (HGS) and subjective global assessment (SGA) were assessed in maintenance HD patients using standard techniques. MAMC was calculated with the formula MAMC (cm) = MAC (cm) -3.142 × TSF cm. Pre-dialysis serum Na values from routine monthly laboratory measurements were averaged for the last 6 months prior to the nutritional assessment. RESULTS: Altogether 172 patients with anthropometric data were included in the final analysis. Mean age was 66 ± 14, females 62 (36%) and diabetics 48 (28.9%). Patients with pre-dialysis serum Na below the mean value (136.2 mEq/L) had lower MAMC, HGS, SGA scores and albumin levels (23.50 ± 3.16 cm versus 24.58 ± 3.71 cm, P = 0.048; 21.7 ± 13.6 kg versus 28.0 ± 12.4 kg, P = 0.030; 5.1 ± 1.2 versus 5.7 ± 1.0, P = 0.012 and 31.65 ± 4.73 mg/L versus 32.25 ± 3.91 mg/L, P = 0.022, respectively) and higher interdialytic weight gains. Pre-dialysis serum Na correlated positively with MAMC, handgrip and SGA (Pearson's correlation r = 0.165, P = 0.031, r = 0.237, P = 0.022 and r = 0.195, P = 0.011, respectively). CONCLUSION: This study demonstrates that low serum sodium is associated with protein energy wasting and increased interdialytic weight gain in HD patients.

Item Type: Article
Additional Information: © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please email: journals.permissions@oup.com. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Keywords: MAMC, hyponatraemia, interdialytic weight gain, malnutrition, thirst
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: Clin Kidney J
ISSN: 2048-8505
Language: eng
Dates:
DateEvent
April 2014Published
20 January 2014Published Online
20 December 2013Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 25852864
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107449
Publisher's version: https://doi.org/10.1093/ckj/sft170

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