Haemodialysis patients with diabetes eat less than those without: A plea for a permissive diet
Open accessAbstract
Aim: The main cause of malnutrition in haemodialysis patients is a spontaneous decline in energy and protein intakes. This study aims to report the dietary energy intake (DEI), dietary protein intake (DPI), and dietary micronutrient intake in a French HD population, to report factors associated with a low DPI and DEI, and to analyze if nutritional intake was correlated with nutritional status. Methods: We conducted an observational cross‐sectional study in a haemodialysis population of 87 adult patients in July 2014. Daily nutritional oral intake, handgrip strength, body composition measured by bioimpedancemetry, and biological and dialysis parameters were obtained from medical records. Statistical analyses of parameters associated with DEI and DPI were performed. Results: The median age (interquartile range) of the population was 77.3 [71.1; 84.8] years, 57.5% were men, and 52.9% had diabetes mellitus. Median weight‐adjusted DEI was 18.4 [15.7;22.3] kcal/kg per day (1308 [1078; 1569] kcal/day), and median weight‐adjusted DPI was 0.80 [0.66; 0.96] g/kg per day (57.5 [47.1; 66.8] g/day). In multivariate analysis, weight‐adjusted DEI was statistically lower in patients with diabetes (coefficient [95%CI] –3.81[−5.21;‐2.41] kcal/kg per day; P = 0.01) but was not associated with the others parameters. When DEI was not adjusted for weight, diabetes was no longer associated with DEI, but female gender (−178[−259;–961] kcal/day; P = 0.03) and a higher Charlson comorbidity index (−30[−44;–15]; P = 0.04) were associated with a lower calorie intake. Results for DPI were similar except that the Charlson comorbidity index did not reach significance. Conclusions: Diabetes is an important factor associated with low dietary intake in haemodialysis patients. Restrictive regimens should be prescribed cautiously in haemodialysis patients, especially in those with diabetes.
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Randomized controlled trials in adults with type 1 diabetes have shown that carbohydrate counting can improve glycemic control, quality of life, and general well-being without increases in severe hypoglycemic events, body weight, or blood lipids.
“carbohydrate counting can improve glycemic control, quality of life, and general well-being”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [173]
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ESPEN guideline on hospital nutrition
Thibault, R., Abbasoglu, O., Ioannou, E., Meija, L., Ottens-Oussoren, K., Pichard, C., Rothenberg, E., Rubin, D., Siljamäki-Ojansuu, U., Vaillant, M.-F., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.09.039 · Cited by 259 · see citing works
- Authors
- Bataille, S., Landrier, J., Astier, J., Cado, S., Sallette, J., Giaime, P., Sampol, J., Sichez, H., Ollier, J., Gugliotta, J., Serveaux, M., Cohen, J., & Darmon, P.
- Affiliations
- Hôpital de la Conception (FR)
- Inserm (FR)
- Cerba laboratory Saint‐Ouen l'Aumône France
- Centre Hospitalier Compiègne-Noyon (FR)
- Phocean Nephrology Institute Clinique Bouchard Marseille France
- Medistats Marseille France
- Corresponding author
- Bataille, Stanislas
- Venue
- Nephrology
- Publisher
- Wiley
- Published
- 2017-08-09
- Volume
- 22
- Issue
- 9
- Pages
- 712-719
- ISSN
- 1320-5358 (ISSN-L)
- 1440-1797
- OpenAlex
- W2416677800
- Cited by
- 15
- References
- 0
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 1
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nephrology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- hemodialysis, diabetes mellitus, energy intake, protein intake, malnutrition, micronutrient intake, nutritional status, grip strength, body composition, Charlson Comorbidity Index
- MeSH terms
- Aged, Aged, 80 and over, Body Composition, Energy Intake, Cross-Sectional Studies, Diabetic Nephropathies, Dietary Proteins, Female, France, Renal Dialysis, Humans, Kidney Failure, Chronic, Male, Nutritional Status, Protein-Energy Malnutrition, Risk Factors, Geriatric Assessment, Nutrition Assessment, Comorbidity, Treatment Outcome, Hand Strength, Recommended Dietary Allowances
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