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Chronic Kidney Disease in South and South East Asia—The Role of Nutrition

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 18720

Special Issue Editor


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Guest Editor
Department of Nutrition & Food Sciences, College of Liberal Arts & Sciences, Wayne State University, Detroit, MI 48202, USA
Interests: chronic kidney disease; dyslipidemia; hemodialysis; renal nutrition; lipoproteins; nutrition education; dietary fats and oil palm nutrition

Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is a major global health issue, afflicting without economic disparities. The progressive decline of the ability of kidneys to remove toxins up to stage five of end-stage renal disease (ESRD), requiring renal replacement therapy (RRT) via dialysis or transplant, presents challenges to the global health community as to human resource availability, healthcare cost decisions, and patient access to resources.  The core of these challenges is sustainability from the viewpoint of the patient for investment in capital for weekly dialysis treatment or access to donated kidneys. Strategies to delay and/or prevent CKD progression to ESRD appear to be outweighed by the RRT options for ESRD. As hypertension and diabetes are two, ever-increasing, major risk factors for CKD/ESRD, the situation is particularly a major health crisis in South Asia. For the South Asia region, little is known about nutritional and lifestyle management in CKD/ESRD. Yet nutrition plays a major role in patient interventions and the nature of delivery, human resource availability, and documentation of patient behaviors and diets against the background of cultural, religious, and socioeconomic disparities within this region is unexplored.

This Special Issue will highlight the latest research emanating from South and Southeast Asia about CKD patient nutrition, identify gaps in knowledge, and provide a platform for strategizing needs-based actions.

Prof. Pramod Khosla
Guest Editor

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Keywords

  • CKD
  • nutrition support
  • inflammation
  • proteinuria
  • dialysis frequency

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Published Papers (2 papers)

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Research

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16 pages, 333 KiB  
Article
HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population
by Mohammad Syafiq Md Ali, Zu-Wei Yeak, Ban-Hock Khor, Sharmela Sahathevan, Ayesha Sualeheen, Jun-Hao Lim, Nurul Iman Hafizah Adanan, Abdul Halim Abdul Gafor, Nor Fadhlina Zakaria, Pramod Khosla, Tilakavati Karupaiah and Zulfitri Azuan Mat Daud
Nutrients 2020, 12(6), 1585; https://doi.org/10.3390/nu12061585 - 28 May 2020
Cited by 5 | Viewed by 4218
Abstract
A rapid and reliable tool appropriate to quantifying macronutrient and micronutrient intakes in diets consumed by Malaysian hemodialysis (HD) patients is lacking. We aimed to develop and validate a novel HD-food frequency questionnaire (HD-FFQ) to assess habitual nutritional intakes of HD patients with [...] Read more.
A rapid and reliable tool appropriate to quantifying macronutrient and micronutrient intakes in diets consumed by Malaysian hemodialysis (HD) patients is lacking. We aimed to develop and validate a novel HD-food frequency questionnaire (HD-FFQ) to assess habitual nutritional intakes of HD patients with diverse ethnic backgrounds. This study was conducted in three phases. In Phase I, a HD-FFQ comprising 118 food items was developed using 3-day diet recalls (3DDR) from 388 HD patients. Phase II was the face and content validation using the Scale-Content Validity Index (S-CVI). After successfully developing the FFQ, Phase III tested relative validation against a reference method, the 3DDR. Results from Phase III showed that the mean difference for absolute intakes of nutrients assessed by HD-FFQ and 3DDR were significant (p < 0.05). However, there was a significant correlation between the HD-FFQ and reference method ranging from 0.35–0.47 (p < 0.05). Cross-quartile classification showed that <10% of patients were grossly misclassified. In conclusion, the HD-FFQ has an acceptable relative validity in assessing and ranking the dietary intake of the HD patients in Malaysia. Full article

Review

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31 pages, 1035 KiB  
Review
Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review
by Sharmela Sahathevan, Ban-Hock Khor, Hi-Ming Ng, Abdul Halim Abdul Gafor, Zulfitri Azuan Mat Daud, Denise Mafra and Tilakavati Karupaiah
Nutrients 2020, 12(10), 3147; https://doi.org/10.3390/nu12103147 - 15 Oct 2020
Cited by 125 | Viewed by 13647
Abstract
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 [...] Read more.
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. Full article
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