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Open AccessReview

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

1
Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
2
Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
3
School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Lakeside Campus, No 1, Jalan Taylors, Subang Jaya 47500, Malaysia
4
Department of Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
5
Post Graduation Program in Medical Sciences and Post-Graduation Program in Cardiovascular Sciences, (UFF), Federal Fluminense University Niterói-Rio de Janeiro (RJ), Niterói-RJ 24033-900, Brazil
6
School of BioSciences, Faculty of Health & Medical Sciences, Taylor’s University Lakeside Campus, No 1, Jalan Taylors, Subang Jaya 47500, Malaysia
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 3147; https://doi.org/10.3390/nu12103147
Received: 23 September 2020 / Revised: 11 October 2020 / Accepted: 13 October 2020 / Published: 15 October 2020
Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies. View Full-Text
Keywords: malnutrition; hemodialysis; iatrogenic; non-iatrogenic factors malnutrition; hemodialysis; iatrogenic; non-iatrogenic factors
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MDPI and ACS Style

Sahathevan, S.; Khor, B.-H.; Ng, H.-M.; Abdul Gafor, A.H.; Mat Daud, Z.A.; Mafra, D.; Karupaiah, T. Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review. Nutrients 2020, 12, 3147. https://doi.org/10.3390/nu12103147

AMA Style

Sahathevan S, Khor B-H, Ng H-M, Abdul Gafor AH, Mat Daud ZA, Mafra D, Karupaiah T. Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review. Nutrients. 2020; 12(10):3147. https://doi.org/10.3390/nu12103147

Chicago/Turabian Style

Sahathevan, Sharmela; Khor, Ban-Hock; Ng, Hi-Ming; Abdul Gafor, Abdul H.; Mat Daud, Zulfitri A.; Mafra, Denise; Karupaiah, Tilakavati. 2020. "Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review" Nutrients 12, no. 10: 3147. https://doi.org/10.3390/nu12103147

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