CHAPTER 4 Nutritional Status on Dialysis - PowerPoint Presentation

Slide1

CHAPTER 4Nutritional Status on Dialysis

Abdul Halim B Abdul GaforTilakavati KarupaiahKoh Keng HeeFairol Huda binti IbrahimThong Kah Mean

Slide2

Table 4.1.1: Distribution of serum albumin, HD patients, 2009-2018

Year

Number of

patients

MeanSDMedianLQUQ% patients<30g/L% patients30-<35g/L% patients35-<40g/L% patients≥40g/L20184231638.44.639.036.041.5415394120174087938.35.138.835.741.3515404020163677638.04.938.735.541.0516423720153421738.24.938.835.741.3516413820143131838.54.939.036.041.5415414120132781938.64.939.036.041.5413424120122453138.85.039.336.341.5413414320112137538.84.939.336.541.5412414320101881238.94.939.336.341.8413404420091694939.45.140.037.042.33113551

Slide3

Figure 4.1.1: Cumulative distribution of serum albumin, HD patients, 2009-2018

Slide4

Table 4.1.2: Distribution of serum albumin, PD patients, 2009-2018

Year

Number of patients

Mean

SDMedianLQUQ% patients<30g/L% patients30-<35g/L% patients35-<40g/L% patients≥40g/L2018542432.36.432.828.336.8333126112017505232.86.633.329.037.0293128112016456632.66.733.028.537.0322927122015421532.76.433.028.837.0303128122014361932.66.833.028.836.8303226112013317233.06.633.329.037.3293128122012280132.66.532.829.036.5313327102011246531.96.032.028.336.035342382010230532.16.232.328.536.033352482009213832.76.433.029.036.830342511

Slide5

Figure 4.1.2: Cumulative distribution of serum albumin, PD patients, 2009-2018

Slide6

Table 4.1.3: Variation in proportion of patients with serum albumin

40g/L among HD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax201873702.029.043.059.075.095201772202.023.040.056.075.096201669602.021.039.052.074.088201567502.023.038.053.073.090201464303.023.042.057.075.091201360006.024.041.057.572.0100201254603.026.042.558.076.096201148806.027.044.058.076.0100201043304.026.044.060.080.0100200938904.037.052.065.085.0100

Slide7

Figure 4.1.3: Variation in proportion of patients with serum albumin

40g/L, HD centres 2018

Slide8

Table 4.1.4: Variation in proportion of patients with serum albumin

40g/L among PD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax20184000.00.09.015.033.54020173800.02.010.017.035.03820163700.02.08.022.035.03620153500.01.011.021.036.04220143200.03.512.020.055.06720132800.02.08.023.531.04020122800.03.010.020.533.03720112600.01.05.521.029.03820102500.02.09.017.029.03220092300.05.014.024.036.037

Slide9

Figure 4.1.4: Variation in proportion of patients with serum albumin

40g/L, PD centres 2018

Slide10

Table 4.2.1: Distribution of BMI, HD patients, 2009-2018

Year

Number of patients

Mean

SDMedianLQUQ% patients<18.5% patients18.5-25% patients>=2520184139624.65.924.021.127.39504220174025224.65.623.921.127.28504120163607824.55.223.921.127.29514120153321924.55.023.921.027.28514020143048124.45.023.821.027.19524020132734824.35.123.720.927.09523920122388424.25.023.720.926.99523820112079024.05.023.520.726.79543720101799223.94.823.420.726.610543620091588123.74.723.220.526.3115435

Slide11

Figure 4.2.1: Cumulative distribution of BMI, HD patients, 2009-2018

Slide12

Table 4.2.2: Distribution of BMI, PD patients, 2009-2018

Year

Number of patients

Mean

SDMedianLQUQ% patients<18.5% patients18.5-25% patients>=252018412224.76.624.121.127.51048422017389024.35.123.920.927.31148412016372424.35.723.920.727.21248402015349924.35.124.020.827.21148412014285724.15.223.720.627.01348392013237624.05.323.620.427.11446402012249524.05.823.620.627.01348392011243024.17.123.620.327.21447392010225224.05.423.720.527.31346402009211023.75.023.620.527.0144739

Slide13

Figure 4.2.2: Cumulative distribution of BMI, PD patients, 2009-2018

Slide14

Table 4.2.3: Variation in proportion of patients with BMI 

18.5 kg/m2 among HD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax201873588189.092.096.01001002017723188188.092.096.01001002016694138288.092.095.01001002015670698289.092.596.0100100201464467988.092.096.0100100201360778088.092.096.01001002012552298088.092.095.51001002011490337888.092.095.01001002010436107787.092.095.01001002009389207685.090.094.0100100

Slide15

Figure 4.2.3: Variation in proportion of patients with BMI 

18.5 kg/m2 among HD centres 2018

Slide16

Table 4.2.4: Variation in proportion of patients with BMI 

18.5 kg/m2 among PD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax201832193384.090.593.510010020172992082.088.093.09597201633141784.090.094.0100100201531141878.088.092.09710020142841783.590.092.5959520132491573.590.094.09810020122591373.086.092.09810020112581378.089.094.09910020102491570.090.592.598100200921141579.089.092.09697

Slide17

Figure 4.2.4: Variation in proportion of patients with BMI 

18.5 kg/m2 among PD centres 2018

Slide18

Table 4.2.5: Variation in proportion of patients with BMI 

18.5 and serum albumin 40 g/dL among HD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax201873002.026.041.054.069.087201772102.021.037.051.070.089201669302.019.037.048.067.088201567202.021.535.050.069.091201464103.022.040.053.070.086201360004.523.539.052.569.095201253902.024.040.054.072.087201148203.026.042.053.071.0100201042803.022.041.056.572.095200937904.033.049.062.078.098

Slide19

Figure 4.2.5: Variation in proportion of patients with BMI 

18.5 kg/m2 and serum albumin 40 g/dL among HD centres 2018

Slide20

Table 4.2.6: Variation in proportion of patients with BMI 

18.5 and serum albumin 40 g/dL among PD centres 2009-2018

Year

Number of centers

Min5th centileLQMedianUQ95th centileMax20183300.00.09.013.028.02920172900.04.010.014.023.02920163400.00.07.018.029.03020153200.01.09.516.031.03120142900.00.09.016.055.06720132500.01.07.019.029.03920122600.01.06.515.024.03020112600.00.04.515.029.03320102500.02.07.012.024.02420092200.03.09.519.026.035

Slide21

Figure 4.2.6: Variation in proportion of patients with BMI 

18.5 kg/m2 and serum albumin 40 g/dL among PD

Slide22

Table 4.3.1: Nutritional parameters between HD and PD patients, 2018

 

HD

PD

P-Valuen= 46153n= 5740 MeanSDMeanSD Age52.7314.1948.8717.04<0.0001bAlbumin (g/dL)38.374.6332.266.38<0.0001bBMI24.645.9224.646.550.8977 bTotal Cholesterol (mmol/L)4.301.024.821.25<0.0001bSr Creatinine (μmol/L)805.53231.71848.99299.47<0.0001bHemoglobin10.311.6110.311.600.2967 ba Independent t-testb Mann Whitney test

Slide23

Table 4.3.2(a): Nutritional parameters between diabetic and non-diabetic HD patients, 2018

 

Diabetes

Non-Diabetes

P-Valuen= 28222n= 17931 MeanSDMeanSD Age56.4311.3846.9116.09<0.0001bAlbumin (g/dL)37.894.6539.104.49<0.0001bBMI25.456.0123.395.55<0.0001bTotal Cholesterol (mmol/L)4.251.054.370.97<0.0001bSr Creatinine (μmol/L)758.48213.88878.02239.31<0.0001bHemoglobin10.241.5910.401.64<0.0001ba Independent t-testb Mann Whitney test

Slide24

Table 4.3.2(b): Nutritional parameters between diabetic and non-diabetic PD patients, 2018

 

Diabetes

Non-Diabetes

P-Valuen= 3119n=2621 MeanSDMeanSD Age56.6011.6239.6817.88<0.0001bAlbumin (g/dL)30.986.4633.765.95<0.0001bBMI25.996.7623.005.88<0.0001bTotal Cholesterol (mmol/L)4.731.294.911.20<0.0001bSr Creatinine (μmol/L)766.68266.77945.32306.88<0.0001bHemoglobin10.421.5210.191.69<0.0001ba Independent t-testb Mann Whitney test

Slide25

Table 4.3.3(a): Distribution of serum albumin and BMI by duration of dialysis among HD patients, 2009-2018

Years

<1

1-<5

5-<10>=10P-Value MeanSDMeanSDMeanSDMeanSD Albumin (g/dL)35.825.2738.273.8339.433.0840.132.840.0001dBMI24.667.9425.045.7824.725.0823.294.260.0001dc ANOVAd Kruskal Wallis rank test

Slide26

Table 4.3.3(b): Distribution of serum albumin and BMI by duration of dialysis among PD patients, 2009-2018

Years

<1

1-<5

5-<10>=10P-Value MeanSDMeanSDMeanSDMeanSD Albumin (g/dL)31.946.8033.265.4634.384.5335.193.670.0001dBMI25.3010.0124.695.7123.314.9821.493.920.0001dc ANOVAd Kruskal Wallis rank test