Nutritional evaluation of hemodialysis patients with and without spinal cord injury.

Both end stage renal disease (ESRD) and spinal cord injury (SCI) represent major disabling conditions that may be associated with protein-calorie malnutrition (PCM). The prevalence of PCM in ESRD, however, remains unknown, and virtually no data exist regarding the status of PCM in patients with both SCI and ESRD. In this study we evaluated 23 ambulatory-ESRD patients and 11 SCI-ESRD patients utilizing a range of parameters recommended for assessing nutritional status in ESRD. Based on these parameters, our results show evidence for PCM in a substantial proportion of both groups. When the two groups were compared, however, the frequency and severity of PCM were significantly greater in the SCI-ESRD patients. Important factors felt to adversely influence nutritional status in the SCI-ESRD patients were intercurrent infection and amyloidosis that were found to frequently complicate this setting. It is also probable that the combined effects of PCM and ESRD significantly predispose these patients to further infection, establishing a vicious cycle.

[1]  G. Guarnieri,et al.  Simple methods for nutritional assessment in hemodialyzed patients. , 1980, The American journal of clinical nutrition.

[2]  J. Kopple,et al.  Methods for assessing nutritional status of patients with renal failure. , 1980, The American journal of clinical nutrition.

[3]  G. Blackburn,et al.  Nutritional assessment and treatment of chronic renal failure. , 1980, The American journal of clinical nutrition.

[4]  C. Musatti,et al.  Immunosuppressive effect of soluble E receptors in uremic serum. , 1979, Clinical immunology and immunopathology.

[5]  K. Raška,et al.  Humoral inhibitors of the immune response in uremia. II. Further characterization of an immunosuppressive factor in uremic serum. , 1979, The American journal of pathology.

[6]  J. Kopple.  Nutritional management of chronic renal failure. , 1978, Postgraduate medicine.

[7]  O. Ringdén,et al.  The effect of uremia and transplantation on lymphocyte subpopulations. , 1976, Kidney international.

[8]  J. Rašková,et al.  A decrease in cell-mediated immunity in uremia associated with an increase in activity of suppressor cells. , 1976, The American journal of pathology.

[9]  N. Scrimshaw,et al.  Cellular immunity in semistarved states in hospitalized adults. , 1975, The American journal of clinical nutrition.

[10]  N. Abdou,et al.  Immunocompetence of patients with protein-calorie malnutrition. The effects of nutritional repletion. , 1973, Annals of internal medicine.

[11]  J. Sanford,et al.  Defective cellular immunity in renal failure: depression of reactivity of lymphocytes to phytohemagglutinin by renal failure serum. , 1971, The Journal of clinical investigation.

[12]  J. Woodruff,et al.  The influence of quantitated post-weaning undernutrition on coxsackievirus B3 infection of adult mice. I. Viral persistence and increased severity of lesions. , 1970, The Journal of infectious diseases.

[13]  E. Sohar,et al.  Deposition of amyloid in the gastrointestinal tract. , 1969, Gut.

[14]  I. Phillips,et al.  Acute bacterial infection in kwashiorkor and marasmus. , 1968, British medical journal.

[15]  C. Tejada,et al.  THE EFFECT OF MALNUTRITION ON THE INFLAMMATORY RESPONSE , 1967, The Journal of experimental medicine.

[16]  R. Nyquist,et al.  Mortality and survival in traumatic myelopathy during nineteen years, from 1946 to 1965 , 1967, Paraplegia.

[17]  R. C. Bunts,et al.  AMYLOIDOSIS IN THE PARAPLEGIC; INCIDENCE AND SIGNIFICANCE. , 1965, The Journal of urology.

[18]  R. Dietrick,et al.  Tabulation and review of autopsy findings in fifty-five paraplegics. , 1958, Journal of the American Medical Association.

[19]  J. Revillard,et al.  T-lymphocytes and serum inhibitors of cell-mediated immunity in renal insufficiency. , 1975, Nephron.

[20]  G. Andrews,et al.  Rheumatoid arthritis with secondary amyloidosis and malabsorption syndrome. Effect of D-penicillamine. , 1968, The American journal of medicine.