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Language: enSubject: hemodialysis

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    Article
    Citation - WoS: 2
    Citation - Scopus: 2
    Upper Extremity Functions and Physical Activity in Chronic Maintenance Hemodialysis Patients: a Case-Control Study
    (Lippincott Williams & Wilkins, 2023) Arslan, Fatma Cansu Aktas; Demirguc, Arzu; Ulug, Naime
    Continuous hemodialysis (HD) treatment causes many complications in patients. The aim of this study is to evaluate the upper extremity functional capacity, physical activity level, and physical functions of patients receiving continuous HD treatment. Fifty HD patients and fifty healthy subjects were included in the study. Hand grip strength with Dynamometer, range of motion of upper extremity with Digital Goniometer, functional level of the upper extremity with the Turkish version of the Shoulder, Arm, and Hand Problems Questionnaire (The DASH-T), physical activity levels with international physical activity questionnaire short form and physical functions with the human activity profile (HAP) were evaluated. The mean grip strength of the subjects in the control group was 23.3 +/- 1.44 kg, while the mean grip strength of the HD patients with fistula was 15.75 +/- 3.08 kg (P < .05). In all joint range of motion measurements; the values of HD patients were significantly lower than the control group (P < .05). The DASH symptom scores of the individuals in the HD group (mean 19.19 +/- 1.41) were significantly higher than the control group (mean 5.75 +/- 1.41) (P < .05). The number of individuals with low-level activity in the HD group (72%) was higher than the control group (34%) (P < .01). The maximum activity score score of the HAP (mean 68.7 +/- 1.4) and the adjusted activity score of the HAP (mean 42.54 +/- 3.02) were lower in the HD group (P < .0001). HD treatment adversely affects hand grip strength, the range of motion, upper extremity functions, physical activity, and physical function levels of the patients.
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    Citation - WoS: 6
    Citation - Scopus: 6
    Effect of Nutritional Support on Nutritional Status and Inflammation in Malnourished Patients Undergoing Maintenance Hemodialysis
    (Wiley, 2021) Demirci, Bahar Gurlek; Carrero, Juan Jesus; Tutal, Emre; Bal, Zeynep; Sezer, Siren
    Introduction Protein energy wasting/malnutrition is a strong predictor of morbidity and mortality in patients on maintenance hemodialysis (MHD). We aimed to compare the effects of oral and/or intradialytic parenteral nutrition (IDPN) support on nutritional and inflammatory parameters in malnourished patients with MHD. Methods This is an observational study of 56 malnourished patients on MHD. We offered combined oral nutritional support (ONS) and IDPN for 12 months to all patients. Depending on patient choices for treatment, they were classified into four groups: group 1 (ONS only), group 2 (IDPN only), group 3 (both ONS and IDPN), and group 4 (patients who refused artificial nutrition support and only followed dietary advice). Normalized protein catabolic rate (nPCR), malnutrition inflammation score (MIS), and body composition (fat mass [FM], muscle mass [MM]) were assessed monthly. Findings The mean serum albumin levels of groups 2 and 3 significantly increased with the intervention, whereas that of group 4 significantly decreased. The mean nPCR levels of groups 2 and 3 significantly increased. Group 3 had the most significant positive change in serum albumin and nPCR levels. Mean serum C-reactive protein (CRP) levels of groups 1, 2, and 3 decreased, whereas those of group 4 increased. A increment in CRP was only identified in group 3. The MIS of groups 1, 2, and 3 significantly decreased whereas that of group 4 significantly increased. The increment % in FM was 1.1, 1.9, 9.1, and -2.9 for groups 1, 2, 3, and 4, respectively, and that in MM was -0.6, 4.4, 6.9, and -7.9 for groups 1, 2, 3, and 4, respectively. Discussion Compared to monotherapy or nutritional counseling, the choice of ONS plus IDPN is associated with improved nutritional status and decreased inflammation in malnourished patients on MHD. Nonetheless, interventional studies must be conducted to confirm these observations.