title: Prevalence of protein-energy wasting (PEW) and evaluation of diagnostic criteria in Japanese maintenance hemodialysis patients.
abstract: OBJECTIVE
  The International Society of Renal Nutrition and Metabolism (ISRNM) has recently recommended the use of the term "protein-energy wasting" (PEW). PEW is a state of malnutrition with decreased body stores of protein and energy fuel in hemodialysis patients and is known as a risk factor for morbidity and mortality. We examined the prevalence of PEW and the characteristics of PEW patients in a hemodialysis center in Japan.
  
  
  METHODS
  Fifty-nine outpatients undergoing maintenance hemodialysis at Iga City General Hospital were evaluated. We observed their biochemical data, body composition, dietary intake, and the number of steps prospectively. PEW was defined according to ISRNM criteria.
  
  
  RESULTS
  Nine patients (15% of total) were diagnosed as having PEW. Among indicators of PEW criteria, the relevance ratios of "reduced muscle mass" and "unintentional low dietary energy intake" were significantly higher in PEW than in non-PEW. The number of steps was lower, and serum levels of glucose and C-reactive protein were higher in PEW.
  
  
  CONCLUSIONS
  About 15% of Japanese hemodialysis patients are estimated to have PEW. Our results suggested that major contributing factors to PEW were reduced muscle mass, unintentional low dietary energy intake, lower amount of exercise, insulin resistance, and chronic inflammation.
authors.affiliation: Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan.|Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.
authors.forename: Sonoko
authors.initials: S
authors.lastname: Yasui
authors.affiliation: Department of Nutrition, Iga City General Hospital, Iga-City, Mie, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Shirai
authors.affiliation: Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan.|Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Tanimura
authors.affiliation: Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan.|Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Matsuura
authors.affiliation: Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan.|Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Dialysis Center, Iga City General Hospital, Iga-City, Mie, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Miyata
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu-City, Mie, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishikawa
authors.affiliation: Department of Surgery, Iga City General Hospital, Iga-City, Mie, Japan.
authors.forename: Chikao
authors.initials: C
authors.lastname: Miki
authors.affiliation: Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-City, Tokushima, Japan. Email: hamada@tokushima-u.ac.jp.|Department of Nutrition, Tokushima University Hospital, Tokushima-City, Tokushima, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hamada
mesh_terms: D000368:Aged; D001786:Blood Glucose; D002097:C-Reactive Protein; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000453:epidemiology*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000628:therapy*; D019282:Wasting Syndrome / Q000453:epidemiology*
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein