Dietary glycemic load (GL) has not been previously reported in HD patients and may be a holistic ... more Dietary glycemic load (GL) has not been previously reported in HD patients and may be a holistic indicator reflective of the dietary profile. Study aim was to quantify GL and assess its relationshi...
As dietitians strive to remain a critical component of the integrative healthcare system, evidenc... more As dietitians strive to remain a critical component of the integrative healthcare system, evidencebased practice must be driven by scientifically and methodologically sound research. Optimally, dietitians should be equitable investigators in all facets of the research process; however, currently our education system does not support this type of participation. The purpose of this program is to pair graduate dietetic students with experienced researchers, providing the opportunity for research from protocol origination to data presentation. This was accomplished by identifying researchers and clinicians who would participate as preceptors. Preceptors provided research areas prior to the first semester each year. Within the first semester, the graduate intern students completed an original protocol and Institutional Review Board application. Concomitantly, students were guided through the protocol by didactic work in a required course. The second semester, 5 hours weekly, was dedicated to data collection and analysis, cumulating in an oral presentation. Future goals include research manuscripts and data on practice impact.
Journal of the American Dietetic Association, 2007
Learning Outcome: Be able to identify the influence of computerassisted instruction on the knowle... more Learning Outcome: Be able to identify the influence of computerassisted instruction on the knowledge gained regarding communication and counseling skills Text: According to the American Dietetic Association, development of effective counseling and communication skills is essential for competent dietetics practice. Various challenges exist for dietetics programs to provide adequate experiences for students. This study uses computerassisted instruction (CAI) as one solution to these challenges. The simulations in the CAI used video and text to illustrate communication and counseling strategies which can develop problem-solving skills necessary to support a client for dietary compliance. Students selected were enrolled in a senior-level dietetics course that included communication and counseling principles. Students completed the pretest, intervention and posttest modules. The intervention included two simulations with experienced RD feedback to the questions asked. No feedback was provided in the pretest and posttest. It was hypothesized that the intervention will enhance the knowledge gained regarding communication and counseling skills. Analysis illustrated that students significantly improved from pretest to posttest. Factorial ANOVA on all independent variables (university, year in school, experience, simulation scores) was performed. Results indicated that simulation scores (Pϭ.001) was the only significant factor in the improvement from pretest to posttest. Simulation scores were categorized into lowest to highest intervention scores with further analysis on whether the students who scored higher in the intervention also improved more from pretest to posttest as compared to students who scored lower. Tukey's test illustrated that the students with the higher simulation scores showed more improvement than those with lower scores. The intervention in the CAI modules helped dietetics students gain knowledge regarding communication and counseling skills.
Objective: The purpose of this study was to determine whether a subjective global assessment (SGA... more Objective: The purpose of this study was to determine whether a subjective global assessment (SGA) score was predictive of healthrelated quality of life (HRQoL) in stage 5 chronic kidney disease patients on maintenance hemodialysis (MHD). Design and Setting: This was a cross-sectional secondary data analysis of MHD patients receiving therapy 3 times a week at dialysis centers located in the United States, Canada, and New Zealand. Nutritional status was assessed using the 7-point SGA. HRQoL was determined using the Medical Outcomes Study 36-item Short Form (SF-36). Results: The study sample consisted of 94 men (n 5 47, 50%) and women (n 5 47, 50%), with a mean age of 64.9 6 12.9 years. The mean SGA score at the end point of the study (6 months) was 5.8 6 1.1. Participants had a mean HRQoL physical health score of 36.5 6 9.3 at 6 months, indicating a worse physical health state. The HRQoL mental health summary score was within the normal range (50.5 6 11.1). After controlling for confounders in the hierarchical regression models, the SGA score significantly predicted HRQoL physical health (R 2 change 5 0.124; P 5 .012). No association was found between the SGA score and HRQoL mental health (P 5 .925). Conclusions: The SGA score is a significant predictor of HRQoL physical health. Given that nutritional status impacts HRQoL and that decreased HRQoL in patients on MHD is associated with mortality, complications, and reduced compliance with treatment, using the SGA to measure nutritional status can be a tool to help identify dialysis patients with a lower HRQoL in terms of physical health.
ABSTRACT The SGA is a clinical tool used to assess protein energy wasting. Although well validate... more ABSTRACT The SGA is a clinical tool used to assess protein energy wasting. Although well validated, it is still not widely incorporated into clinical practice. A barrier to use may be the physical assessment section. Therefore, the purpose of this project was to develop a free and effective tool to train clinicians on performing the SGA. Second Life (SL) is a free virtual reality program accessed through the internet using human-like “avatars.” A museum environment was created with panels presenting SGA background information through text, images, and videos of SGA being performed. Users are able to navigate the information by logging onto a provided avatar. After the initial panels, this avatar is able to interact with avatar bots and perform animations which mimic each body assessment within the SGA. Two trial periods were conducted to assess the efficacy of this training tool. The alpha trial consisted of 3 hospital dietitians and 3 nutrition students. These subjects came to the investigators’ facility to test the program. Subjective responses were collected and used to improve the training tool. Feedback was positive regarding the information, delivery, and direction of the project; however, they did complain of difficulty with controlling the avatar. The beta trial consists of users accessing the module remotely. These users include academic and clinical dietitians. Responses are being collected via 5 surveys covering each portion of the module. While 16 dietitians responded to the beta trial, only 4 have completed the training. Current survey responses state: the use of SL is easy and enjoyable; all SGA information was clear and in a desirable format; tactile comparison objects were beneficial for understanding; the in depth description of each assessment is beneficial; the animations that the avatars perform on the bots needs improvement; a patient avatar on which users could perform the full SGA is desirable; the use of SL in the learning process is beneficial, but it can also be distracting; the module increased the users’ familiarity, confidence, and desire to employ the SGA, amongst both current users and those new to the SGA. In summary, this training tool provides clinicians a free and effective way to learn the SGA.
ABSTRACT Renal dietitians lack sufficient time to complete formal diet assessments according to p... more ABSTRACT Renal dietitians lack sufficient time to complete formal diet assessments according to previous research. The goal of this pilot study was to determine the validity of dietitians' subjective assessments of their patients' diets using the Modified Appetite and Diet Assessment Tool (MADAT). Testing compared dietitian-subjective assessment with nutrient analysis software results; dietitian perceptions of the tool were also collected. Dietitians were more successful at judging the adequacy of protein and energy intake than micronutrient intake; however, the small sample size was a limitation. Dietitians were positive about the tool, suggesting that further testing should be done to implement MADAT in practice.
ABSTRACT Previous research indicated that renal dietitians lack the time and computer software to... more ABSTRACT Previous research indicated that renal dietitians lack the time and computer software to implement the KDOQI nutrition guidelines for assessing dietary intake. This study used an online survey to determine the frequency and method of collecting and analyzing dietary intake data among renal dietitians in the USA and overseas. The link to the survey was emailed to the members of the RenalRD listserve (n=2077), the International Society of Renal Nutrition and Metabolism (n=93), the Academy of Nutrition and Dietetics Renal Practice Group (n=2362), and the National Kidney Foundation Council on Renal Nutrition (n=1491). Only currently practicing renal dietitians were asked to respond; 599 usable responses were received. A response rate cannot be calculated due to membership overlap between the 4 organizations, although individuals were asked to answer only once. Respondents were 99% female, 91% worked in the USA, 45% had a M.S. degree or higher, and 21% were Board Certified Specialists in Renal Nutrition. Dietitians worked mostly in dialysis (hospital based facility 30%, Fresenius 18%, DaVita 17%) and 5% worked in a pre-dialysis CKD clinic. Median patient load was 120/Full Time Equivalent (inner quartile range 100-150). Dietitians reported that they collected dietary intake data most frequently when labs were abnormal (70%), yearly (41%), and at the first visit only (35%). They did not collect intake data more frequently due to lack of time (42%) and not having analysis software (24.9%). Only 10% of renal dietitians reported that the frequency of diet analysis was determined by following the KDOQI guidelines, while 58.5% reported deciding on their own when to collect data. The most common methods of data collection were the “typical day” recall (50%) and the 24-hour recall (37%). Only 8% reported using a 3-day food record (as recommended by KDOQI). Methods of diet analysis were “estimation in my head” (62%), “calculate by hand” (25%), computer software (6%) and internet analysis sites (7%). These data show that most dietitians are not following the KDOQI nutrition guidelines for frequency or method of diet analysis, and new, inexpensive, and rapid methods of diet assessment must be explored.
ABSTRACT A previous pilot test on an online nutrition care algorithm for patients on hemodialysis... more ABSTRACT A previous pilot test on an online nutrition care algorithm for patients on hemodialysis showed that the algorithm was able to track nutrition changes over time; however, use of the algorithm took time beyond usual care. This study piloted methodology to compare outcomes between patients who received 2 hours with the dietitian each month with or without the algorithm. Data were collected at baseline and 6 months. Outcomes did not differ significantly, although patterns of change in risk factors for serum parathyroid hormone and serum phosphorus varied. The small sample size limits conclusions about outcomes but shows that the methodology is feasible.
To develop and validate the Guide for Effective Nutrition Interventions and Education (GENIE), a ... more To develop and validate the Guide for Effective Nutrition Interventions and Education (GENIE), a checklist of research-based quality indicators for nutrition education programs. A prospective test of criterion validity and inter-rater reliability of a new tool comparing expert assessments and trained reviewer GENIE scores of the same nutrition education proposals. Ten nutrition education experts; 13 volunteer reviewers. GENIE's face, content, and criterion validity and inter-rater reliability compared using expert assessments and reviewer objective and subjective scores. Reviewer scores compared using Spearman correlation. Inter-rater reliability tested using intra-class correlation (ICC), Cronbach alpha, and ANOVA. Criterion validity tested using independent t test and point bi-serial correlation to compare reviewer with expert scores. Correlation found between total objective and total subjective scores. Agreement found between reviewers across proposals and categories considering subjective scores (F = 7.21, P < .001; ICC = 0.76 [confidence interval, 0.53-0.92]) and objective scores (F = 7.88, P < .001; ICC = 0.82 [confidence interval, 0.63-0.94]). Relationship was not significant (r = .564, P = .06) between expert and reviewer proposal scoring groups (high, medium, and low). Results support the validity and reliability of GENIE as a tool for nutrition education practitioners, researchers, and program funding agencies to accurately assess the quality of a variety of nutrition program plans.
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2014
The objective of this study was to determine the relationship between serum albumin and the Subje... more The objective of this study was to determine the relationship between serum albumin and the Subjective Global Assessment (SGA) in a sample of obese hemodialysis (HD) patients. Study subjects (N = 253) included patients who were categorized into well-nourished (68%, SGA score 6-7) and malnourished (score 1-5) groups, and, on the basis of the body mass index (BMI), into obese (BMI > 30 kg/m(2); 35%) and nonobese (BMI < 30 kg/m(2)). The mean baseline data (±standard deviation) were as follows: age, 63.5 ± 14.3 years; BMI, 29 ± 8 kg/m(2); and serum albumin, 3.8 ± 0.4 mg/dL (bromocresol green). The secondary analysis of data from the SGA Validation Project and Nutrition Algorithm Preliminary Report determined the relationship between the 7-point SGA and serum albumin concentrations in a sample of obese HD patients. Data were analyzed at Case Western Reserve University from a total of 253 HD patients. The SGA scores in the BMI groups were compared with serum albumin as an objective ...
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2012
It has been reported that hemodialysis patients have elevated plasma acylcarnitine concentrations... more It has been reported that hemodialysis patients have elevated plasma acylcarnitine concentrations, which correlates to reduced red blood cell integrity. It has also been reported that the supplementation of L-carnitine for these patients improves anemia, glucose metabolism and muscle function, but the mechanism of these relationships remains unknown. We hypothesized that the cause of increased plasma acylcarnitines is incomplete fatty acid oxidation and the underlying disturbance of metabolism reduces muscle function, resulting in decreased ability to function and quality of life, and glucose availability, resulting in decreased red blood cell integrity and worsened anemia. This analysis was conducted on baseline data from a clinical trial of carnitine supplementation in hemodialysis patients with reduced physical function and free carnitine levels. Partial correlations controlling for age, gender, hemoglobin and subjective global assessment score for each acylcarnitine species and ...
Reactive oxygen species play critical roles in the development and progression of diabetic nephro... more Reactive oxygen species play critical roles in the development and progression of diabetic nephropathy (DN). To evaluate the effect of antioxidant therapy on renal damage, we investigated the effect of green tea catechin on oxidative stress-induced renal cell damage in LLC-PK cells and DN induced by subtotal nephrectomy plus streptozotocin injection in rats, Antioxidant activities of 6 green tea catechins were evaluated by 1,1-diphenyl-2picrylhydrazyl (DPPH) radical scavenging activity test. Protective effect of (-)epigallocatechin 3-O-gallate (EGCG) as a representative tea catechin against oxidative renal cell damage was measured in LLC-PK cells. EGCG showed the strongest DPPH radical scavenging activity and protected renal epithelial LLC-PK cells from oxidative damage in the dose-dependent manner. Hyperglycemia, proteinuria and the elevated lipid peroxidation levels were reduced by EGCG administration. The renal protein expressions related to diabetic nephropathy such as iNOS, COX-2, NF-kB, phosphorylated IkB-a, TGF-b1 and fibronectin were significantly decreased after EGCG treatment.
Dietary glycemic load (GL) has not been previously reported in HD patients and may be a holistic ... more Dietary glycemic load (GL) has not been previously reported in HD patients and may be a holistic indicator reflective of the dietary profile. Study aim was to quantify GL and assess its relationshi...
As dietitians strive to remain a critical component of the integrative healthcare system, evidenc... more As dietitians strive to remain a critical component of the integrative healthcare system, evidencebased practice must be driven by scientifically and methodologically sound research. Optimally, dietitians should be equitable investigators in all facets of the research process; however, currently our education system does not support this type of participation. The purpose of this program is to pair graduate dietetic students with experienced researchers, providing the opportunity for research from protocol origination to data presentation. This was accomplished by identifying researchers and clinicians who would participate as preceptors. Preceptors provided research areas prior to the first semester each year. Within the first semester, the graduate intern students completed an original protocol and Institutional Review Board application. Concomitantly, students were guided through the protocol by didactic work in a required course. The second semester, 5 hours weekly, was dedicated to data collection and analysis, cumulating in an oral presentation. Future goals include research manuscripts and data on practice impact.
Journal of the American Dietetic Association, 2007
Learning Outcome: Be able to identify the influence of computerassisted instruction on the knowle... more Learning Outcome: Be able to identify the influence of computerassisted instruction on the knowledge gained regarding communication and counseling skills Text: According to the American Dietetic Association, development of effective counseling and communication skills is essential for competent dietetics practice. Various challenges exist for dietetics programs to provide adequate experiences for students. This study uses computerassisted instruction (CAI) as one solution to these challenges. The simulations in the CAI used video and text to illustrate communication and counseling strategies which can develop problem-solving skills necessary to support a client for dietary compliance. Students selected were enrolled in a senior-level dietetics course that included communication and counseling principles. Students completed the pretest, intervention and posttest modules. The intervention included two simulations with experienced RD feedback to the questions asked. No feedback was provided in the pretest and posttest. It was hypothesized that the intervention will enhance the knowledge gained regarding communication and counseling skills. Analysis illustrated that students significantly improved from pretest to posttest. Factorial ANOVA on all independent variables (university, year in school, experience, simulation scores) was performed. Results indicated that simulation scores (Pϭ.001) was the only significant factor in the improvement from pretest to posttest. Simulation scores were categorized into lowest to highest intervention scores with further analysis on whether the students who scored higher in the intervention also improved more from pretest to posttest as compared to students who scored lower. Tukey's test illustrated that the students with the higher simulation scores showed more improvement than those with lower scores. The intervention in the CAI modules helped dietetics students gain knowledge regarding communication and counseling skills.
Objective: The purpose of this study was to determine whether a subjective global assessment (SGA... more Objective: The purpose of this study was to determine whether a subjective global assessment (SGA) score was predictive of healthrelated quality of life (HRQoL) in stage 5 chronic kidney disease patients on maintenance hemodialysis (MHD). Design and Setting: This was a cross-sectional secondary data analysis of MHD patients receiving therapy 3 times a week at dialysis centers located in the United States, Canada, and New Zealand. Nutritional status was assessed using the 7-point SGA. HRQoL was determined using the Medical Outcomes Study 36-item Short Form (SF-36). Results: The study sample consisted of 94 men (n 5 47, 50%) and women (n 5 47, 50%), with a mean age of 64.9 6 12.9 years. The mean SGA score at the end point of the study (6 months) was 5.8 6 1.1. Participants had a mean HRQoL physical health score of 36.5 6 9.3 at 6 months, indicating a worse physical health state. The HRQoL mental health summary score was within the normal range (50.5 6 11.1). After controlling for confounders in the hierarchical regression models, the SGA score significantly predicted HRQoL physical health (R 2 change 5 0.124; P 5 .012). No association was found between the SGA score and HRQoL mental health (P 5 .925). Conclusions: The SGA score is a significant predictor of HRQoL physical health. Given that nutritional status impacts HRQoL and that decreased HRQoL in patients on MHD is associated with mortality, complications, and reduced compliance with treatment, using the SGA to measure nutritional status can be a tool to help identify dialysis patients with a lower HRQoL in terms of physical health.
ABSTRACT The SGA is a clinical tool used to assess protein energy wasting. Although well validate... more ABSTRACT The SGA is a clinical tool used to assess protein energy wasting. Although well validated, it is still not widely incorporated into clinical practice. A barrier to use may be the physical assessment section. Therefore, the purpose of this project was to develop a free and effective tool to train clinicians on performing the SGA. Second Life (SL) is a free virtual reality program accessed through the internet using human-like “avatars.” A museum environment was created with panels presenting SGA background information through text, images, and videos of SGA being performed. Users are able to navigate the information by logging onto a provided avatar. After the initial panels, this avatar is able to interact with avatar bots and perform animations which mimic each body assessment within the SGA. Two trial periods were conducted to assess the efficacy of this training tool. The alpha trial consisted of 3 hospital dietitians and 3 nutrition students. These subjects came to the investigators’ facility to test the program. Subjective responses were collected and used to improve the training tool. Feedback was positive regarding the information, delivery, and direction of the project; however, they did complain of difficulty with controlling the avatar. The beta trial consists of users accessing the module remotely. These users include academic and clinical dietitians. Responses are being collected via 5 surveys covering each portion of the module. While 16 dietitians responded to the beta trial, only 4 have completed the training. Current survey responses state: the use of SL is easy and enjoyable; all SGA information was clear and in a desirable format; tactile comparison objects were beneficial for understanding; the in depth description of each assessment is beneficial; the animations that the avatars perform on the bots needs improvement; a patient avatar on which users could perform the full SGA is desirable; the use of SL in the learning process is beneficial, but it can also be distracting; the module increased the users’ familiarity, confidence, and desire to employ the SGA, amongst both current users and those new to the SGA. In summary, this training tool provides clinicians a free and effective way to learn the SGA.
ABSTRACT Renal dietitians lack sufficient time to complete formal diet assessments according to p... more ABSTRACT Renal dietitians lack sufficient time to complete formal diet assessments according to previous research. The goal of this pilot study was to determine the validity of dietitians&#39; subjective assessments of their patients&#39; diets using the Modified Appetite and Diet Assessment Tool (MADAT). Testing compared dietitian-subjective assessment with nutrient analysis software results; dietitian perceptions of the tool were also collected. Dietitians were more successful at judging the adequacy of protein and energy intake than micronutrient intake; however, the small sample size was a limitation. Dietitians were positive about the tool, suggesting that further testing should be done to implement MADAT in practice.
ABSTRACT Previous research indicated that renal dietitians lack the time and computer software to... more ABSTRACT Previous research indicated that renal dietitians lack the time and computer software to implement the KDOQI nutrition guidelines for assessing dietary intake. This study used an online survey to determine the frequency and method of collecting and analyzing dietary intake data among renal dietitians in the USA and overseas. The link to the survey was emailed to the members of the RenalRD listserve (n=2077), the International Society of Renal Nutrition and Metabolism (n=93), the Academy of Nutrition and Dietetics Renal Practice Group (n=2362), and the National Kidney Foundation Council on Renal Nutrition (n=1491). Only currently practicing renal dietitians were asked to respond; 599 usable responses were received. A response rate cannot be calculated due to membership overlap between the 4 organizations, although individuals were asked to answer only once. Respondents were 99% female, 91% worked in the USA, 45% had a M.S. degree or higher, and 21% were Board Certified Specialists in Renal Nutrition. Dietitians worked mostly in dialysis (hospital based facility 30%, Fresenius 18%, DaVita 17%) and 5% worked in a pre-dialysis CKD clinic. Median patient load was 120/Full Time Equivalent (inner quartile range 100-150). Dietitians reported that they collected dietary intake data most frequently when labs were abnormal (70%), yearly (41%), and at the first visit only (35%). They did not collect intake data more frequently due to lack of time (42%) and not having analysis software (24.9%). Only 10% of renal dietitians reported that the frequency of diet analysis was determined by following the KDOQI guidelines, while 58.5% reported deciding on their own when to collect data. The most common methods of data collection were the “typical day” recall (50%) and the 24-hour recall (37%). Only 8% reported using a 3-day food record (as recommended by KDOQI). Methods of diet analysis were “estimation in my head” (62%), “calculate by hand” (25%), computer software (6%) and internet analysis sites (7%). These data show that most dietitians are not following the KDOQI nutrition guidelines for frequency or method of diet analysis, and new, inexpensive, and rapid methods of diet assessment must be explored.
ABSTRACT A previous pilot test on an online nutrition care algorithm for patients on hemodialysis... more ABSTRACT A previous pilot test on an online nutrition care algorithm for patients on hemodialysis showed that the algorithm was able to track nutrition changes over time; however, use of the algorithm took time beyond usual care. This study piloted methodology to compare outcomes between patients who received 2 hours with the dietitian each month with or without the algorithm. Data were collected at baseline and 6 months. Outcomes did not differ significantly, although patterns of change in risk factors for serum parathyroid hormone and serum phosphorus varied. The small sample size limits conclusions about outcomes but shows that the methodology is feasible.
To develop and validate the Guide for Effective Nutrition Interventions and Education (GENIE), a ... more To develop and validate the Guide for Effective Nutrition Interventions and Education (GENIE), a checklist of research-based quality indicators for nutrition education programs. A prospective test of criterion validity and inter-rater reliability of a new tool comparing expert assessments and trained reviewer GENIE scores of the same nutrition education proposals. Ten nutrition education experts; 13 volunteer reviewers. GENIE&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s face, content, and criterion validity and inter-rater reliability compared using expert assessments and reviewer objective and subjective scores. Reviewer scores compared using Spearman correlation. Inter-rater reliability tested using intra-class correlation (ICC), Cronbach alpha, and ANOVA. Criterion validity tested using independent t test and point bi-serial correlation to compare reviewer with expert scores. Correlation found between total objective and total subjective scores. Agreement found between reviewers across proposals and categories considering subjective scores (F = 7.21, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001; ICC = 0.76 [confidence interval, 0.53-0.92]) and objective scores (F = 7.88, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001; ICC = 0.82 [confidence interval, 0.63-0.94]). Relationship was not significant (r = .564, P = .06) between expert and reviewer proposal scoring groups (high, medium, and low). Results support the validity and reliability of GENIE as a tool for nutrition education practitioners, researchers, and program funding agencies to accurately assess the quality of a variety of nutrition program plans.
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2014
The objective of this study was to determine the relationship between serum albumin and the Subje... more The objective of this study was to determine the relationship between serum albumin and the Subjective Global Assessment (SGA) in a sample of obese hemodialysis (HD) patients. Study subjects (N = 253) included patients who were categorized into well-nourished (68%, SGA score 6-7) and malnourished (score 1-5) groups, and, on the basis of the body mass index (BMI), into obese (BMI > 30 kg/m(2); 35%) and nonobese (BMI < 30 kg/m(2)). The mean baseline data (±standard deviation) were as follows: age, 63.5 ± 14.3 years; BMI, 29 ± 8 kg/m(2); and serum albumin, 3.8 ± 0.4 mg/dL (bromocresol green). The secondary analysis of data from the SGA Validation Project and Nutrition Algorithm Preliminary Report determined the relationship between the 7-point SGA and serum albumin concentrations in a sample of obese HD patients. Data were analyzed at Case Western Reserve University from a total of 253 HD patients. The SGA scores in the BMI groups were compared with serum albumin as an objective ...
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2012
It has been reported that hemodialysis patients have elevated plasma acylcarnitine concentrations... more It has been reported that hemodialysis patients have elevated plasma acylcarnitine concentrations, which correlates to reduced red blood cell integrity. It has also been reported that the supplementation of L-carnitine for these patients improves anemia, glucose metabolism and muscle function, but the mechanism of these relationships remains unknown. We hypothesized that the cause of increased plasma acylcarnitines is incomplete fatty acid oxidation and the underlying disturbance of metabolism reduces muscle function, resulting in decreased ability to function and quality of life, and glucose availability, resulting in decreased red blood cell integrity and worsened anemia. This analysis was conducted on baseline data from a clinical trial of carnitine supplementation in hemodialysis patients with reduced physical function and free carnitine levels. Partial correlations controlling for age, gender, hemoglobin and subjective global assessment score for each acylcarnitine species and ...
Reactive oxygen species play critical roles in the development and progression of diabetic nephro... more Reactive oxygen species play critical roles in the development and progression of diabetic nephropathy (DN). To evaluate the effect of antioxidant therapy on renal damage, we investigated the effect of green tea catechin on oxidative stress-induced renal cell damage in LLC-PK cells and DN induced by subtotal nephrectomy plus streptozotocin injection in rats, Antioxidant activities of 6 green tea catechins were evaluated by 1,1-diphenyl-2picrylhydrazyl (DPPH) radical scavenging activity test. Protective effect of (-)epigallocatechin 3-O-gallate (EGCG) as a representative tea catechin against oxidative renal cell damage was measured in LLC-PK cells. EGCG showed the strongest DPPH radical scavenging activity and protected renal epithelial LLC-PK cells from oxidative damage in the dose-dependent manner. Hyperglycemia, proteinuria and the elevated lipid peroxidation levels were reduced by EGCG administration. The renal protein expressions related to diabetic nephropathy such as iNOS, COX-2, NF-kB, phosphorylated IkB-a, TGF-b1 and fibronectin were significantly decreased after EGCG treatment.
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