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Relation of protein energy wasting to carotid intima media thickness in hemodialysis patients

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Abstract

Carotid intima media thickness (CIMT) can reflect the degree of atherosclerosis and cardiovascular risk in hemodialysis patients. Factors such as advanced age, male gender, family history, and smoking can increase the risk of CIMT. In hemodialysis (HD) patients, lower serum albumin level was found to be correlated with higher CIMT. This study aimed to evaluate the relation between CIMT and protein energy wasting (PEW) diagnosed according to the diagnostic criteria of International Society of Renal Nutrition and Metabolism (ISRNM) expert panel in HD patients. This study involved 45 HD patients who were divided into two groups according to the diagnostic criteria for PEW proposed by the ISRNM expert panel including group with PEW (11 patients) and group without PEW (34 patients). Caloric intake was evaluated by food frequency questionnaire for 3 days. Subjective global assessment (SGA) and malnutrition inflammation score (MIS) were fulfilled. Anthropometric measurements, as well as body composition, was evaluated by electrical bioimpedance analysis. Doppler ultrasonography was used to assess CIMT that was significantly higher in patients with PEW (p = 0.030). CIMT had significant positive correlation to age, SGA, and MIS (p = 0.008, 0.002, and 0.003, respectively). Significant negative correlation was observed between CIMT and serum albumin. Multiple linear regression analysis revealed that serum albumin was the only predictor of mean CIMT. In conclusion, CIMT seems to be related to malnutrition in HD patients. Low serum albumin was the only predictor of CIMT.

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Authors and Affiliations

  1. Mansoura Nephrology and Dialysis Unit (MNDU), Mansoura Faculty of Medicine, Mansoura, Egypt

    Mostafa Mahmoud, Eman Nagy, Mohamed AbdAlBary, Ghada El-Kannishy & Nagy Sayed-Ahmed

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  1. Mostafa Mahmoud
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  2. Eman Nagy
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  3. Mohamed AbdAlBary
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  4. Ghada El-Kannishy
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  5. Nagy Sayed-Ahmed
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Correspondence to Ghada El-Kannishy.

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The authors declare that they have no conflict of interest.

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The Institutional Research Board (IRB) of our institute approve study protocol.

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Informed written consent was obtained from each participant in the study after assuring confidentiality.

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Mahmoud, M., Nagy, E., AbdAlBary, M. et al. Relation of protein energy wasting to carotid intima media thickness in hemodialysis patients. J Hum Hypertens 35, 598–603 (2021). https://doi.org/10.1038/s41371-020-0376-7

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