Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol
Abstract Background Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inf...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-02-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-018-0819-3 |
| _version_ | 1819274234547929088 |
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| author | Joanne Reid Helen R. Noble Gary Adamson Andrew Davenport Ken Farrington Denis Fouque Kamyar Kalantar-Zadeh John Mallett C. McKeaveney S. Porter David S. Seres Joanne Shields Adrian Slee Miles D. Witham Alexander P. Maxwell |
| author_facet | Joanne Reid Helen R. Noble Gary Adamson Andrew Davenport Ken Farrington Denis Fouque Kamyar Kalantar-Zadeh John Mallett C. McKeaveney S. Porter David S. Seres Joanne Shields Adrian Slee Miles D. Witham Alexander P. Maxwell |
| author_sort | Joanne Reid |
| collection | DOAJ |
| description | Abstract Background Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD. Individuals with ESKD often exhibit symptoms of anorexia, loss of lean muscle mass and altered energy expenditure. These symptoms are consistent with the syndrome of cachexia observed in other chronic diseases, such as cancer, heart failure, and acquired immune deficiency syndrome. While definitions of cachexia have been developed for some diseases, such as cardiac failure and cancer, no specific cachexia definition has been established for chronic kidney disease. The importance of developing a definition of cachexia in a population with ESKD is underscored by the negative impact that symptoms of cachexia have on quality of life and the association of cachexia with a substantially increased risk of premature mortality. The aim of this study is to determine the clinical phenotype of cachexia specific to individuals with ESKD. Methods A longitudinal study which will recruit adult patients with ESKD receiving haemodialysis attending a Regional Nephrology Unit within the United Kingdom. Patients will be followed 2 monthly over 12 months and measurements of weight; lean muscle mass (bioelectrical impedance, mid upper arm muscle circumference and tricep skin fold thickness); muscle strength (hand held dynamometer), fatigue, anorexia and quality of life collected. We will determine if they experience (and to what degree) the known characteristics associated with cachexia. Discussion Cachexia is a debilitating condition associated with an extremely poor outcome. Definitions of cachexia in chronic illnesses are required to reflect specific nuances associated with each disease. These discrete cachexia definitions help with the precision of research and the subsequent clinical interventions to improve outcomes for patients suffering from cachexia. The absence of a definition for cachexia in an ESKD population makes it particularly difficult to study the incidence of cachexia or potential treatments, as there are no standardised inclusion criteria for patients with ESKD who have cachexia. Outcomes from this study will provide much needed data to inform development and testing of potential treatment modalities, aimed at enhancing current clinical practice, policy and education. |
| first_indexed | 2024-12-23T23:05:11Z |
| format | Article |
| id | doaj.art-93fd9be874fd497f9b887e5e759ea47a |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-23T23:05:11Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-93fd9be874fd497f9b887e5e759ea47a2022-12-21T17:26:49ZengBMCBMC Nephrology1471-23692018-02-011911610.1186/s12882-018-0819-3Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocolJoanne Reid0Helen R. Noble1Gary Adamson2Andrew Davenport3Ken Farrington4Denis Fouque5Kamyar Kalantar-Zadeh6John Mallett7C. McKeaveney8S. Porter9David S. Seres10Joanne Shields11Adrian Slee12Miles D. Witham13Alexander P. Maxwell14School of Nursing and Midwifery, Queen’s University Belfast Medical Biology CentreSchool of Nursing and Midwifery, Queen’s University Belfast Medical Biology CentreSchool of Psychology, Ulster University Magee CampusUCL Centre for Nephrology, Royal Free Hospital, University College LondonEast and North Hertfordshire University NHS Trust, Lister HospitalDepartment of Nephrology, Université de Lyon, UCBL, Carmen, Centre Hospitalier Lyon SudDivision of Nephrology and Hypertension, Pediatrics and Public Health, University of CaliforniaSchool of Psychology, Ulster University Magee CampusSchool of Nursing and Midwifery, Queen’s University Belfast Medical Biology CentreDepartment of Social Sciences and Social Work, Bournemouth UniversityColumbia University Medical Centre, NY Presbyterian HospitalRegional Nephrology Unit, Belfast City Hospital, Belfast HSC TrustUCL, Faculty of Medical SciencesSchool of Medicine, Ninewells HospitalSchool of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast and Regional Nephrology Unit, Belfast City Hospital, Belfast HSC TrustAbstract Background Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD. Individuals with ESKD often exhibit symptoms of anorexia, loss of lean muscle mass and altered energy expenditure. These symptoms are consistent with the syndrome of cachexia observed in other chronic diseases, such as cancer, heart failure, and acquired immune deficiency syndrome. While definitions of cachexia have been developed for some diseases, such as cardiac failure and cancer, no specific cachexia definition has been established for chronic kidney disease. The importance of developing a definition of cachexia in a population with ESKD is underscored by the negative impact that symptoms of cachexia have on quality of life and the association of cachexia with a substantially increased risk of premature mortality. The aim of this study is to determine the clinical phenotype of cachexia specific to individuals with ESKD. Methods A longitudinal study which will recruit adult patients with ESKD receiving haemodialysis attending a Regional Nephrology Unit within the United Kingdom. Patients will be followed 2 monthly over 12 months and measurements of weight; lean muscle mass (bioelectrical impedance, mid upper arm muscle circumference and tricep skin fold thickness); muscle strength (hand held dynamometer), fatigue, anorexia and quality of life collected. We will determine if they experience (and to what degree) the known characteristics associated with cachexia. Discussion Cachexia is a debilitating condition associated with an extremely poor outcome. Definitions of cachexia in chronic illnesses are required to reflect specific nuances associated with each disease. These discrete cachexia definitions help with the precision of research and the subsequent clinical interventions to improve outcomes for patients suffering from cachexia. The absence of a definition for cachexia in an ESKD population makes it particularly difficult to study the incidence of cachexia or potential treatments, as there are no standardised inclusion criteria for patients with ESKD who have cachexia. Outcomes from this study will provide much needed data to inform development and testing of potential treatment modalities, aimed at enhancing current clinical practice, policy and education.http://link.springer.com/article/10.1186/s12882-018-0819-3End-stage kidney diseaseCachexiaPhenotypeDefinitionLongitudinal |
| spellingShingle | Joanne Reid Helen R. Noble Gary Adamson Andrew Davenport Ken Farrington Denis Fouque Kamyar Kalantar-Zadeh John Mallett C. McKeaveney S. Porter David S. Seres Joanne Shields Adrian Slee Miles D. Witham Alexander P. Maxwell Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol BMC Nephrology End-stage kidney disease Cachexia Phenotype Definition Longitudinal |
| title | Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol |
| title_full | Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol |
| title_fullStr | Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol |
| title_full_unstemmed | Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol |
| title_short | Establishing a clinical phenotype for cachexia in end stage kidney disease – study protocol |
| title_sort | establishing a clinical phenotype for cachexia in end stage kidney disease study protocol |
| topic | End-stage kidney disease Cachexia Phenotype Definition Longitudinal |
| url | http://link.springer.com/article/10.1186/s12882-018-0819-3 |
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