Instıtute of Health Sciences Journal
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Hemodiyaliz Hastalarında Beslenme Durumunun Değerlendirilmesinde Yeni Bir Yöntem: Faz Açısı

Year 2023, Volume: 8 Issue: 1, 58 - 64, 30.04.2023

Sema ÇALAPKORUR Elif İRADELİ

https://doi.org/10.51754/cusbed.1136058

Abstract

Kronik böbrek hastalığı ülkemizde ve dünyada prevalansı giderek artan bir halk sağlığı problemidir. Son dönem böbrek yetmezliğine sahip bireyler yaşamlarını devam ettirebilmek için diyaliz veya renal transplantasyon tedavisi almaktadır. Hemodiyaliz, renal replasman tedavileri arasında en fazla tercih edilen seçenektir. Hemodiyaliz tedavisindeki gelişmelere rağmen malnütrisyon hemodiyaliz tedavisi alan hastalarda görülen yaygın bir durumdur. Hemodiyaliz hastalarında görülen malnütrisyon artmış morbidite ve mortalite ile ilişkilidir. Malnütrisyonun saptanması hemodiyaliz hastalarında klinik sonuçların iyileştirilmesi için gereklidir. Beslenme durumunun belirlenmesinde altın standart bir yöntem bulunmamaktadır. Son dönem böbrek yetmezliği yaşayan hastalarda beslenmenin değerlendirilmesinde birçok farklı yöntem kullanılmaktadır. Vücut kompozisyonunun değerlendirilmesinde kullanılan biyoelektrik impedans analizi bu yöntemlerden bir tanesidir. Biyoelektrik impedans analizi ile belirlenen faz açısı değeri, hücre membran hasarının ve vücut hücre kütlesinin bir göstergesidir. Faz açısı beslenme durumunun değerlendirilmesi için kullanılan objektif bir değerdir. Faz açısı, hemodiyaliz hastalarında beslenme durumunu saptanması için yararlı bir parametre olarak görülmektedir. Bu derleme ile biyoelektrik impedans analiz cihazıyla ölçülen faz açısını açıklamak, hemodiyaliz tedavisi alan hastalarda faz açısının beslenme durumuyla olan ilişkisini değerlendirmek amaçlanmaktadır.

Keywords

beslenme, faz açısı, Hemodiyaliz

References

  • Badrasawi, M., Zidan, S., Sharif, I., Qaisiyha, J., Ewaida, S., Jaradat, T., & Samamra Y. (2021). Prevalence and correlates of malnutrition among hemodialysis patients at hebron governmental hospital, Palestine: Crosssectional study. BMC Nephrology, 22(1), 1-12. https://doi.org/10.1186/s12882-021-02413-y
  • Beberashvili, I., Azar, A., Sinuani, I., Shapiro, G., Feldman, L., Stav, K., Sandbank, J., & Averbukh, Z. (2014). Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. European Journal of Clinical Nutrition, 68(6), 683-689. https://doi.org/10.1038/ejcn.2014.67
  • Bossola, M., Muscaritoli, M., Tazza, L., Giungi, S., Tortorelli, A., Rossi Fanelli, F., & Luciani, G. (2005). Malnutrition in hemodialysis patients: What therapy? American Journal of Kidney Diseases, 46(3), 371-386. https://doi.org/10.1053/j.ajkd.2005.05.031
  • Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., Compher, C., Correia, I., Higashiguchi, T., Holst, M., Jensen, G. L., Malone, A., Muscaritoli, M., Nyulasi, I., Pirlich, M., Rothenberg, E., Schindler, K., Schneider, S. M., de van der Schueren M. A., … Singer, P. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition, 36(1), 49-64. https://doi.org/10.1016/j.clnu.2016.09.004
  • Cederholm, T., Jensen, G. L., Correia, M. I. T. D., Gonzalez, M. C., Fukushima, R., Higashiguchi, T., Baptista, G., Barazzoni, R., Blaauw, R., Coats, A., Crivelli, A., Evans, D. C., Gramlich, L., Fuchs-Tarlovsky, V., Keller, H., Llido, L., Malone, A., Mogensen, K. M., Morley, J. E., … GLIM Core Leadership Committee, GLIM Working Group. (2019). GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community. Clinical Nutrition, 38(1), 207-217. https://doi.org/10.1002/jcsm.12383
  • Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management: A review. JAMA, 322(13), 1294-1304. https://doi.org/10.1001/jama.2019.14745
  • Correia, M. I. T. D., Perman, M. I., & Waitzberg, D. L. (2017). Hospital malnutrition in Latin America: A systematic review. Clinical Nutrition, 36(4), 958-967 https://doi.org/10.1016/j.clnu.2016.06.025
  • Di Vincenzo, O., Marra, M., & Scalfi, L. (2019). Bioelectrical impedance phase angle in sport: A systematic review. Journal of the International Society of Sports Nutrition, 16(1), 49. https://doi.org/10.1186/s12970-019-0319-2
  • Donini, L. M., Savina, C., Rosano, A., & Cannella, C. (2007). Systematic review of nutritional status evaluation and screening tools in the elderly. Journal of Nutrition Health and Aging, 11(5), 421.
  • Dos Reis, A. S., Santos, H. O., Limirio, L. S., & de Oliveira, E. P. (2019). Phase angle is associated with handgrip strength but not with sarcopenia in kidney transplantation patients. Journal of Renal Nutrition, 29(3), 196-204. https://doi.org/10.1053/j.jrn.2018.10.005
  • Ferrie, S. (2020). What is nutritional assessment? A quick guide for critical care clinicians. Australian Critical Care, 33(3), 295-299. https://doi.org/10.1016/j.aucc.2020.02.005
  • Garlini, L. M., Alves, F. D., Ceretta, L. B., Perry, I. S., Souza, G. C., & Clausell, N. O. (2019). Phase angle and mortality: A systematic review. European journal of clinical nutrition, 73(4), 495-508. https://doi.org/10.1038/s41430-018-0159-1
  • Grundmann, O., Yoon, S. L., & Williams, J. J. (2015). The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients-a comprehensive review. European journal of clinical Nutrition, 69(12), 1290-1297. https://doi.org/10.1038/ejcn.2015.126
  • Himmelfarb, J., & Ikizler, T. A. (2010). Hemodialysis. New England Journal of Medicine, 363(19), 1833-1845. https://doi.org/10.1056/nejmra0902710
  • Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., Saran, R., Wang, A. Y., & Yang, C. W. (2013). Chronic kidney disease: Global dimension and perspectives. Lancet, 382(9888), 260-272. https://doi.org/10.1016/s0140-6736(13)60687-x
  • Kalantar-Zadeh, K., Joshi, S., Schlueter, R., Cooke, J., Brown-Tortorici, A., Donnelly, M., Schulman, S., Lau, W. L., Rhee, C. M., Streja, E., Tantisattamo, E., Ferrey, A. J., Hanna, R., Chen, J. L. T., Malik, S., Nguyen, D. V., Crowley, S. T., & Kovesdy, C. P. (2020). Plant-dominant low-protein diet for conservative management of chronic kidney disease. Nutrients, 12(7), 1931. https://doi.org/10.3390/nu12071931
  • Karavetian, M., Salhab, N., Rizk, R., & Poulia, K. A. (2019). Malnutrition-inflammation score vs phase angle in the era of GLIM criteria: A cross-sectional study among hemodialysis patients in UAE. Nutrients, 11(11), 2771. https://doi.org/10.3390/nu11112771
  • Lee, J. E., Jo, I. Y., Lee, S. M., Kim, W. J., Choi, H. Y., Ha, S. K., Kim, H. J., & Park, H. C. (2015). Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis. Clinical Interventions in Aging, 10, 1327-1334. https://doi.org/10.2147/cia.s86229
  • Li, T., Liu, J., An, S., Dai, Y., & Yu, Q. (2014). Body mass index and mortality in patients on maintenance hemodialysis: A meta-analysis. International Urology and Nephrology, 46(3), 623-631. https://doi.org/10.1007/s11255-014-0653-x
  • Lukaski, H. C., Kyle, U. G., & Kondrup, J. (2017). Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: Phase angle and impedance ratio. Clinical Nutrition and Metabolic Care, 20(5), 330-339. https://doi.org/10.1097/mco.0000000000000387
  • Ma, L., & Zhao, S. (2017). Risk factors for mortality in patients undergoing hemodialysis: A systematic review and meta-analysis. International Journal of Cardiology, 238, 151-158. https://doi.org/10.1016/j.ijcard.2017.02.095
  • Maggiore, Q., Nigrelli, S., Ciccarelli, C., Grimaldi, C., Rossi, G. A., & Michelassi, C. (1996). Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney International, 50(6), 2103-2108. https://doi.org/10.1038/ki.1996.535
  • McQuillan, R., Trpeski, L., Fenton, S., & Lok, C. E. (2012). Modifiable risk factors for early mortality on hemodialysis. International Journal of Nephrology, 2012. https://doi.org/10.1155/2012/435736
  • Mueller, C., Compher, C., Ellen, D. M., & American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors (2011). A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. Journal of Parenteral and Enteral Nutrition, 35(1), 16-24. https://doi.org/10.1177/0148607110389335
  • Mulasi, U., Kuchnia, A. J., Cole, A. J., & Earthman, C. P. (2015). Bioimpedance at the bedside: Current applications, limitations, and opportunities. Nutrition in Clinical Practice, 30(2), 180-193. https://doi.org/10.1177/0884533614568155 Norman, K., Stobäus, N., Pirlich, M., & Bosy-Westphal, A. (2012). Bioelectrical phase angle and impedance vector analysis--clinical relevance and applicability of impedance parameters. Clinical Nutrition, 31(6), 854-861. https://doi.org/10.1016/j.clnu.2012.05.008
  • Oliveira, C. M., Kubrusly, M., Mota, R. S., Silva, C. A., Choukroun, G., & Oliveira, V. N. (2010). The phase angle and mass body cell as markers of nutritional status in hemodialysis patients. Journal of Renal Nutrition, 20(5), 314-320. https://doi.org/10.1053/j.jrn.2010.01.008
  • Pekcan, G. (2014). Beslenme durumunun saptanması. Içinde A. Baysal (Ed), Diyet el kitabı, (8. baskı, ss. 67-143). Hatipoglu Yayinevi.
  • Reber, E., Gomes, F., Vasiloglou, M. F., Schuetz, P., & Stanga, Z. (2019). Nutritional risk screening and assessment. Journal of Clinical Medicine, 8(7), 1065. https://doi.org/10.3390/jcm8071065
  • Rimsevicius, L., Gincaite, A., Vicka, V., Sukackiene, D., Pavinic, J., & Miglinas, M. (2016). Malnutrition assessment in hemodialysis patients: Role of bioelectrical impedance analysis. Journal of Renal Nutrition, 26(6), 391-395. https://doi.org/10.1053/j.jrn.2016.05.004
  • Robinson, B. M., Zhang, J., Morgenstern, H., Bradbury, B. D., Ng, L. J., McCullough, K. P., Gillespie, B. W., Hakim, R., Rayner, H., Fort, J., Akizawa, T., Tentori, F., & Pisoni, R. L. (2014). Worldwide, mortality risk is high soon after initiation of hemodialysis. Kidney International, 85(1), 158-165. https://doi.org/10.1038/ki.2013.252
  • Rosenberger, J., Kissova, V., Majernikova, M., Straussova, Z., & Boldizsar, J. (2014). Body composition monitor assessing malnutrition in the hemodialysis population independently predicts mortality. Journal of Renal Nutrition, 24(3):172-176. https://doi.org/10.1053/j.jrn.2014.01.002
  • Sahathevan, S., Khor, B. H., Ng, H. M., Gafor, A. H. A., Mat Daud, Z. A., Mafra, D., & Karupaiah, T. (2020). Understanding development of malnutrition in hemodialysis patients: A narrative review. Nutrients, 12(10), 3147. https://doi.org/10.3390/nu12103147
  • Saitoh, M., Ogawa, M., Kondo, H., Suga, K., Takahashi, T., Itoh, H., & Tabata, Y. (2020). Bioelectrical impedance analysis-derived phase angle as a determinant of protein-energy wasting and frailty in maintenance hemodialysis patients: Retrospective cohort study. BMC Nephrology, 21(1), 1-8. https://doi.org/10.1186/s12882-020-02102-2
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A New Method for Evaluating Nutritional Status in Hemodialysis Patients: Phase Angle

Year 2023, Volume: 8 Issue: 1, 58 - 64, 30.04.2023

Sema ÇALAPKORUR Elif İRADELİ

https://doi.org/10.51754/cusbed.1136058

Abstract

Chronic kidney disease is a public health problem with an increasing prevalence in our country and in the world. Individuals with end-stage chronic kidney disease receive dialysis or renal transplantation therapy to maintain their lives. Hemodialysis is the most preferred option among renal replacement therapies. Despite advances in hemodialysis therapy, malnutrition is a common condition in patients receiving hemodialysis therapy. Malnutrition in hemodialysis patients is associated with increased morbidity and mortality. Detection of malnutrition is essential for improving clinical outcomes in hemodialysis patients. There is no gold standard method for determining nutritional status. Many different methods are used in the assessment of nutrition in patients with end-stage chronic renal failure. Bioelectrical impedance analysis, which is used in the assessment of body composition, is one of these methods. The phase angle value determined by bioelectrical impedance analysis is an indicator of cell membrane damage and body cell mass. The phase angle is an objective value used to evaluate nutritional status. The phase angle is seen as a useful parameter for assessing nutritional status in hemodialysis patients. This review, it is aimed to explain the phase angle measured with a bioelectrical impedance analyzer and to evaluate the relationship of the phase angle with nutritional status in patients receiving hemodialysis treatment.

Keywords

Hemodialysis, nutrition, phase angle

References

  • Badrasawi, M., Zidan, S., Sharif, I., Qaisiyha, J., Ewaida, S., Jaradat, T., & Samamra Y. (2021). Prevalence and correlates of malnutrition among hemodialysis patients at hebron governmental hospital, Palestine: Crosssectional study. BMC Nephrology, 22(1), 1-12. https://doi.org/10.1186/s12882-021-02413-y
  • Beberashvili, I., Azar, A., Sinuani, I., Shapiro, G., Feldman, L., Stav, K., Sandbank, J., & Averbukh, Z. (2014). Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. European Journal of Clinical Nutrition, 68(6), 683-689. https://doi.org/10.1038/ejcn.2014.67
  • Bossola, M., Muscaritoli, M., Tazza, L., Giungi, S., Tortorelli, A., Rossi Fanelli, F., & Luciani, G. (2005). Malnutrition in hemodialysis patients: What therapy? American Journal of Kidney Diseases, 46(3), 371-386. https://doi.org/10.1053/j.ajkd.2005.05.031
  • Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., Compher, C., Correia, I., Higashiguchi, T., Holst, M., Jensen, G. L., Malone, A., Muscaritoli, M., Nyulasi, I., Pirlich, M., Rothenberg, E., Schindler, K., Schneider, S. M., de van der Schueren M. A., … Singer, P. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition, 36(1), 49-64. https://doi.org/10.1016/j.clnu.2016.09.004
  • Cederholm, T., Jensen, G. L., Correia, M. I. T. D., Gonzalez, M. C., Fukushima, R., Higashiguchi, T., Baptista, G., Barazzoni, R., Blaauw, R., Coats, A., Crivelli, A., Evans, D. C., Gramlich, L., Fuchs-Tarlovsky, V., Keller, H., Llido, L., Malone, A., Mogensen, K. M., Morley, J. E., … GLIM Core Leadership Committee, GLIM Working Group. (2019). GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community. Clinical Nutrition, 38(1), 207-217. https://doi.org/10.1002/jcsm.12383
  • Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management: A review. JAMA, 322(13), 1294-1304. https://doi.org/10.1001/jama.2019.14745
  • Correia, M. I. T. D., Perman, M. I., & Waitzberg, D. L. (2017). Hospital malnutrition in Latin America: A systematic review. Clinical Nutrition, 36(4), 958-967 https://doi.org/10.1016/j.clnu.2016.06.025
  • Di Vincenzo, O., Marra, M., & Scalfi, L. (2019). Bioelectrical impedance phase angle in sport: A systematic review. Journal of the International Society of Sports Nutrition, 16(1), 49. https://doi.org/10.1186/s12970-019-0319-2
  • Donini, L. M., Savina, C., Rosano, A., & Cannella, C. (2007). Systematic review of nutritional status evaluation and screening tools in the elderly. Journal of Nutrition Health and Aging, 11(5), 421.
  • Dos Reis, A. S., Santos, H. O., Limirio, L. S., & de Oliveira, E. P. (2019). Phase angle is associated with handgrip strength but not with sarcopenia in kidney transplantation patients. Journal of Renal Nutrition, 29(3), 196-204. https://doi.org/10.1053/j.jrn.2018.10.005
  • Ferrie, S. (2020). What is nutritional assessment? A quick guide for critical care clinicians. Australian Critical Care, 33(3), 295-299. https://doi.org/10.1016/j.aucc.2020.02.005
  • Garlini, L. M., Alves, F. D., Ceretta, L. B., Perry, I. S., Souza, G. C., & Clausell, N. O. (2019). Phase angle and mortality: A systematic review. European journal of clinical nutrition, 73(4), 495-508. https://doi.org/10.1038/s41430-018-0159-1
  • Grundmann, O., Yoon, S. L., & Williams, J. J. (2015). The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients-a comprehensive review. European journal of clinical Nutrition, 69(12), 1290-1297. https://doi.org/10.1038/ejcn.2015.126
  • Himmelfarb, J., & Ikizler, T. A. (2010). Hemodialysis. New England Journal of Medicine, 363(19), 1833-1845. https://doi.org/10.1056/nejmra0902710
  • Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., Saran, R., Wang, A. Y., & Yang, C. W. (2013). Chronic kidney disease: Global dimension and perspectives. Lancet, 382(9888), 260-272. https://doi.org/10.1016/s0140-6736(13)60687-x
  • Kalantar-Zadeh, K., Joshi, S., Schlueter, R., Cooke, J., Brown-Tortorici, A., Donnelly, M., Schulman, S., Lau, W. L., Rhee, C. M., Streja, E., Tantisattamo, E., Ferrey, A. J., Hanna, R., Chen, J. L. T., Malik, S., Nguyen, D. V., Crowley, S. T., & Kovesdy, C. P. (2020). Plant-dominant low-protein diet for conservative management of chronic kidney disease. Nutrients, 12(7), 1931. https://doi.org/10.3390/nu12071931
  • Karavetian, M., Salhab, N., Rizk, R., & Poulia, K. A. (2019). Malnutrition-inflammation score vs phase angle in the era of GLIM criteria: A cross-sectional study among hemodialysis patients in UAE. Nutrients, 11(11), 2771. https://doi.org/10.3390/nu11112771
  • Lee, J. E., Jo, I. Y., Lee, S. M., Kim, W. J., Choi, H. Y., Ha, S. K., Kim, H. J., & Park, H. C. (2015). Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis. Clinical Interventions in Aging, 10, 1327-1334. https://doi.org/10.2147/cia.s86229
  • Li, T., Liu, J., An, S., Dai, Y., & Yu, Q. (2014). Body mass index and mortality in patients on maintenance hemodialysis: A meta-analysis. International Urology and Nephrology, 46(3), 623-631. https://doi.org/10.1007/s11255-014-0653-x
  • Lukaski, H. C., Kyle, U. G., & Kondrup, J. (2017). Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: Phase angle and impedance ratio. Clinical Nutrition and Metabolic Care, 20(5), 330-339. https://doi.org/10.1097/mco.0000000000000387
  • Ma, L., & Zhao, S. (2017). Risk factors for mortality in patients undergoing hemodialysis: A systematic review and meta-analysis. International Journal of Cardiology, 238, 151-158. https://doi.org/10.1016/j.ijcard.2017.02.095
  • Maggiore, Q., Nigrelli, S., Ciccarelli, C., Grimaldi, C., Rossi, G. A., & Michelassi, C. (1996). Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney International, 50(6), 2103-2108. https://doi.org/10.1038/ki.1996.535
  • McQuillan, R., Trpeski, L., Fenton, S., & Lok, C. E. (2012). Modifiable risk factors for early mortality on hemodialysis. International Journal of Nephrology, 2012. https://doi.org/10.1155/2012/435736
  • Mueller, C., Compher, C., Ellen, D. M., & American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors (2011). A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. Journal of Parenteral and Enteral Nutrition, 35(1), 16-24. https://doi.org/10.1177/0148607110389335
  • Mulasi, U., Kuchnia, A. J., Cole, A. J., & Earthman, C. P. (2015). Bioimpedance at the bedside: Current applications, limitations, and opportunities. Nutrition in Clinical Practice, 30(2), 180-193. https://doi.org/10.1177/0884533614568155 Norman, K., Stobäus, N., Pirlich, M., & Bosy-Westphal, A. (2012). Bioelectrical phase angle and impedance vector analysis--clinical relevance and applicability of impedance parameters. Clinical Nutrition, 31(6), 854-861. https://doi.org/10.1016/j.clnu.2012.05.008
  • Oliveira, C. M., Kubrusly, M., Mota, R. S., Silva, C. A., Choukroun, G., & Oliveira, V. N. (2010). The phase angle and mass body cell as markers of nutritional status in hemodialysis patients. Journal of Renal Nutrition, 20(5), 314-320. https://doi.org/10.1053/j.jrn.2010.01.008
  • Pekcan, G. (2014). Beslenme durumunun saptanması. Içinde A. Baysal (Ed), Diyet el kitabı, (8. baskı, ss. 67-143). Hatipoglu Yayinevi.
  • Reber, E., Gomes, F., Vasiloglou, M. F., Schuetz, P., & Stanga, Z. (2019). Nutritional risk screening and assessment. Journal of Clinical Medicine, 8(7), 1065. https://doi.org/10.3390/jcm8071065
  • Rimsevicius, L., Gincaite, A., Vicka, V., Sukackiene, D., Pavinic, J., & Miglinas, M. (2016). Malnutrition assessment in hemodialysis patients: Role of bioelectrical impedance analysis. Journal of Renal Nutrition, 26(6), 391-395. https://doi.org/10.1053/j.jrn.2016.05.004
  • Robinson, B. M., Zhang, J., Morgenstern, H., Bradbury, B. D., Ng, L. J., McCullough, K. P., Gillespie, B. W., Hakim, R., Rayner, H., Fort, J., Akizawa, T., Tentori, F., & Pisoni, R. L. (2014). Worldwide, mortality risk is high soon after initiation of hemodialysis. Kidney International, 85(1), 158-165. https://doi.org/10.1038/ki.2013.252
  • Rosenberger, J., Kissova, V., Majernikova, M., Straussova, Z., & Boldizsar, J. (2014). Body composition monitor assessing malnutrition in the hemodialysis population independently predicts mortality. Journal of Renal Nutrition, 24(3):172-176. https://doi.org/10.1053/j.jrn.2014.01.002
  • Sahathevan, S., Khor, B. H., Ng, H. M., Gafor, A. H. A., Mat Daud, Z. A., Mafra, D., & Karupaiah, T. (2020). Understanding development of malnutrition in hemodialysis patients: A narrative review. Nutrients, 12(10), 3147. https://doi.org/10.3390/nu12103147
  • Saitoh, M., Ogawa, M., Kondo, H., Suga, K., Takahashi, T., Itoh, H., & Tabata, Y. (2020). Bioelectrical impedance analysis-derived phase angle as a determinant of protein-energy wasting and frailty in maintenance hemodialysis patients: Retrospective cohort study. BMC Nephrology, 21(1), 1-8. https://doi.org/10.1186/s12882-020-02102-2
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Details

Primary Language Turkish
Subjects Medicine
Journal Section Review
Authors

Sema ÇALAPKORUR
ERCIYES UNIVERSITY
0000-0002-2540-1957
Türkiye

Elif İRADELİ
ERCİYES ÜNİVERSİTESİ
0000-0001-7554-6225
Türkiye

Early Pub Date April 26, 2023
Publication Date April 30, 2023
Published in Issue Year 2023Volume: 8 Issue: 1

Cite

APA Çalapkorur, S. & İradeli, E. (2023). Hemodiyaliz Hastalarında Beslenme Durumunun Değerlendirilmesinde Yeni Bir Yöntem: Faz Açısı . Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi , 8 (1) , 58-64 . DOI: 10.51754/cusbed.1136058
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