Study of Effect of Optimization of Dialysis and Protein Intake on Neuromuscular Function in Patients under Maintenance Hemodialysis Treatment

Abstract

This study was carried out on 22 patients on maintenance hemodialysis. Among them, 20 patients were males and 2 were females, their age ranged from 12 to 50 years. Initially, the patients were assessed clinically and by laboratory investigations and their dialysis was assessed by studying their urea kinetic modeling following the nomographic approach for calculating their Kt/V values. Their nutrition was assessed by measuring skin folds, midarm circumference, laboratory parameters and by calculating the normalized protein catabolic rate (nPCR). Also their neuromuscular functions were assessed by clinical examination and neurophysiologic study. Dialysis dose was readjusted to achieve a target Kt/V value of 1.3 for patients on 3 times weekly dialysis and 1.6 for patients on twice weekly dialysis. Also, their nutrition was reviewed to achieve nPCR 1.2 g/kg/day and caloric intake 30–40 kcal/kg/day through diet manipulation and support. The patients were assessed finally after 3 months on targeted dialysis and nutrition by thorough clinical, laboratory and neuromuscular assessment.Analysis of neurophysiologic data showed significant improvement in electromyography. Furthermore, fatigue test showed significant (p = 0.002) decreases in muscle fatigue after optimization of dialysis dose and patients’ nutrition.From this study, we may conclude that in dialysis patients, even when asymptomatic and clinically stable, neurologic deficits do exist and using area kinetic modeling to improve dialysis and patients’ nutrition is valuable in improving their neuromuscular functions.

Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 1998

Publication date (Print): October 1998

Publication date (Electronic): 10 September 1998

Volume: 18

Issue: 5

Pages: 399-403

Affiliations

^a Urology and Nephrology Center and ^b Neurology Department, Mansoura University, Mansoura, Egypt

Article

Publisher ID: 13383 Other ID: Am J Nephrol 1998;18:399–403

DOI: 10.1159/000013383

PubMed ID: 9730563

Copyright statement: © 1998 S. Karger AG, Basel

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Page count

Tables: 3, References: 17, Pages: 5

Product

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Categories

Subject: Clinical Study