ABSTRACT
Nutrition therapy is considered as the basis for prevention and management of chronic kidney disease (CKD), throughout the three-tier prevention strategies of CKD. The primary objective is to delay the disease progression, correct metabolic disorders, and improve the outcomes of CKD. Low protein diet has been recognized as an important therapeutic measure in CKD, but the quantity, quality and source of protein are always the points of contention. Recently, both domestic and foreign guidelines have been updated on the amount of protein intake. In addition to quantity, attention has been paid to the type and diversity of proteins. With the rise of plant-based food consumption and the concept of vegetarian diet, the scientific community began to review the benefits of plant protein again, and a plant-based diet is recommend extensively. Whether the plant-based dietary pattern is also suitable for CKD patients who need a low-protein diet, and whether it could meet the nutritional needs of CKD patients are hot topics, this article reviews the recent progress of these research hotspots.
ABSTRACT
Objective To evaluate the prevalence and distribution characteristics of fatigue in maintaining hemodialysis in China. Methods Literature search was conducted to collect cross-sectional studies on the prevalence of fatigue in maintenance hemodialysis in PubMed,The Cochrane Library, Embase, Web of Science,China National Knowledge Internet,China Biology Medicine and Wan Fang Data. The studies were selected according to the exclusion and inclusive criteria and the qualities of studies were evaluated. Meta-analysis was performed with software of Stata 14.0. Results A total of 19 studies, including a total size of 3171 and 2253 patients of fatigue,were eligible for inclusion in the review.The prevalence of fatigue by analyzing the effect size was 72.1％(95％ CI 63.6％-80.6％),the prevalence of mild to moderate fatigue by analyzing the effect size was 15.8％(95％ CI 7.0％-24.7％), 43.6％(95％ CI 40.1％-47.1％) and the prevalence of severe fatigue was 19.8％(95％CI 12.0％-27.6％).Subgroup analyses indicated that the fatigue rate of female maintenance hemodialysis was higher than male,the prevalence level estimated by the Piper Fatigue revised scale was higher than other tools(80.8％),the prevalence level estimated by the Vitality Subscale of the SF-36 (SF-36 VS), Short-Form Health Survey was lower than other tools(46.8％).The fatigue rate in the central and western areas were higher than that of the eastern region.The harder the economic was,the higher the prevalence of fatigue was.The prevalence of fatigue in the population dialysis aged 6 to 10 years was lower than that in dialysis age≤5 and dialysis age>10 years. Sensitivity analysis showed that the pooled effect size had good stability and reliability. ConclusionS The prevalence of fatigue in maintenance hemodialysis in China is high,which suggest that we should paymore attention to this situation.There are differences in the prevalence of fatigue in maintenance hemodialysis patients on different scales, areas, sex, dialysis years, and economic.