{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:01:02Z","timestamp":1783771262910,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,15]],"date-time":"2022-05-15T00:00:00Z","timestamp":1652572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The protein\u2010energy wasting (PEW) syndrome is a common complication in hemodialysis (HD) patients associated to morbidity and mortality. Our objective was to assess the prevalence of PEW and its association with erythropoietin resistance index (ERI) score, body composition by impedance, health\u2010related quality of life, and muscle strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional, observational, multicenter study, we included data from 191 HD patients from three HD clinics located in Mexico City, Mexico. Clinical and biochemistry variables, body composition, handgrip strength, and the KDQOL\u2010SF36 questionnaire were collected for each patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Prevalence of PEW was 22% (<jats:italic>n<\/jats:italic>\u00a0=\u00a041\/191), with a higher frequency in those with diabetes mellitus (59% vs. 49%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Subjects with PEW had lower hemoglobin levels (9.5\u2009+\u20091.6\u00a0g\/dl vs. 10.3\u2009+\u20091.7\u00a0g\/dl; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.005) and higher ERI scores (19.2\u2009\u00b1\u200911.2 vs. 15.6\u2009\u00b1\u20098.2; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04) compared with the non\u2010PEW group. In analysis of body composition, PEW was associated to higher overhydration status (42.2 vs. 24.9 OH\/kg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.009), higher extracellular water (263\u2009\u00b1\u200940 vs. 246\u2009\u00b1\u200932\u2009ml\/kg; <jats:italic>p\u2009=<\/jats:italic>\u00a00.019), lower lean tissue index (12.2\u2009\u00b1\u20093.2 vs. 14.1\u2009\u00b1\u20093.7\u00a0ml\/m<jats:sup>2<\/jats:sup>; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.021), and lower fat tissue index (9.6\u2009\u00b1\u20095.7 vs. 12.3\u2009\u00b1\u20096.2\u00a0ml\/m<jats:sup>2<\/jats:sup>; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.043). Handgrip strength was lower in PEW patients (22.5 vs. 28.1\u00a0kg; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). Finally, no significant differences were observed between groups in quality\u2010of\u2010life assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this study, PEW was associated to poor responsiveness to erythropoiesis\u2010stimulating agents, lower muscle strength, and higher overhydration status due to the increase in extracellular water which replaced the loss of tissue. Nevertheless, quality\u2010of\u2010life assessment was not different in patients with PEW compared with those without this complication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.13022","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T03:53:43Z","timestamp":1652673223000},"page":"415-423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Anemia, overhydration, and lower muscle strength in hemodialysis patients with protein\u2010energy wasting"],"prefix":"10.1111","volume":"26","author":[{"given":"Carlos A.","family":"Ch\u00e1vez\u2010Mendoza","sequence":"first","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-4521","authenticated-orcid":false,"given":"Armando J.","family":"Mart\u00ednez\u2010Rueda","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Ortega\u2010Vargas","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivonne K.","family":"Becerra\u2010Laparra","sequence":"additional","affiliation":[{"name":"Medica Sur Clinic &amp; Foundation  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Ardav\u00edn\u2010Ituarte","sequence":"additional","affiliation":[{"name":"Medica Sur Clinic &amp; Foundation  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Correa\u2010Rotter","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-2941","authenticated-orcid":false,"given":"Juan C.","family":"Ram\u00edrez\u2010Sandoval","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-4842","authenticated-orcid":false,"given":"Olynka","family":"Vega\u2010Vega","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2018.08.006"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"e_1_2_6_4_1","first-page":"1","article-title":"Enfermedad renal cr\u00f3nica y su atenci\u00f3n mediante tratamiento sustitutivo en M\u00e9xico. 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