Extension of Healthy Life Span of Dialysis Patients in the Era of a 100-Year Life
A special issue of Nutrients (ISSN 2072-6643).
Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 77674
Special Issue Editors
Interests: sarcopenia/frailty in CKD patients; clinical significance; nutritional support for patients
Interests: insulin resistance; insulin signaling; atherosclerosis; vascular calcification; diabetic nephropathy; renal failure
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Special Issue Information
Dear Colleagues,
Malnutrition has become a greater health problem with an increasing number of elderly CKD patients on dialysis. Malnutrition is a frequent complication in the CKD population, which is now increasingly recognized as a significant risk factor for adverse outcomes such as higher mortality, higher rates of hospitalization, and poorer quality of life in such patients. We previously found that malnutrition develops preferentially in dialysis patients complicated with diabetes, inflammation, sarcopenia/frailty, and CVD, each of which is a definite and independent risk factor associated with higher mortality, although it is possible that malnutrition could increase mortality by exacerbating such factors. The positive impact of nutritional support to dialysis patients has been well established from the standpoint of mortality and quality of life. Although the restriction of protein intake has been recommended to protect progressive decline in eGFR in CKD patients, it is widely recognized that such protein restriction might accelerate the loss of skeletal muscle in CKD patients who have already suffered from uremic sarcopenia. Increased protein and calorie intake or oral protein-based nutritional supplements, particularly from animal sources, to malnourished dialysis patients is important in increasing serum albumin, muscle mass, and adipose mass to prevent against the development of sarcopenia/frailty. However, although increased protein and calorie intake might increase serum phosphate, a biological toxin, leading to the development of vascular calcification and subsequent poorer prognosis, it is shown that an improved nutritional state rather than hyperphosphatemia might be preferred based on survival rate. The simultaneous introduction of exercise therapy, particularly by isotonic exercise, is needed to increase muscle mass together with the increase of food and nutrient intake. Furthermore, the frequent deficiency of micronutrients, and thus the importance of their sufficient intake, is also recognized, as well as the homeostasis of electrolytes. Finally, new techniques such as MRI are also expected to quantitate malnutrition in dialysis patients to justify early intervention.
This Special Issue will update knowledge on the frequent occurrence of malnourished dialysis patients, and its prevention and treatment to improve quality of life and extend healthy life expectancy. To prevent the onset and development of malnutrition in dialysis patients, it should be emphasized that comprehensive care by a wide variety of medical staff is essential.
The issue will comprise manuscripts of papers presented in the symposium sessions related to nutrition at the 2020 65th Annual Meeting of the Japanese Society for Dialysis Therapy: Extension of Healthy Life Span of Dialysis Patients in the Era of 100-Year Life (https://site.convention.co.jp/65jsdt/).
Dr. Masaaki Inaba
Prof. Dr. Katsuhiko Mori
Guest Editors
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Keywords
- Malnutrition
- CKD
- diabetes, dialysis
- sarcopenia
- frailty
- skeletal muscle
- adipose tissue
- phosphate
- trace elements
- potassium
- zinc
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