{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:53:03Z","timestamp":1789750383804,"version":"4.0.1"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The population of end-stage renal disease (ESRD) patients with diabetes mellitus (DM) may be at increased risk of protein energy wasting (PEW). The aim of the study was to investigate the impact of DM on selected indicators of PEW in the ESRD population that was undergoing maintenance hemodialysis (MHD). Methods: A total of 515 MHD patients were divided into two subgroups with and without DM. The evaluation of diet composition, Charlson Comorbidity Index (CCI), SGA, and laboratory and BIS analyses were performed. All-cause and cardiovascular mortality was recorded. Results: DM patients had lower albumin (3.93 (3.61\u20134.20) vs. 4.10 (3.80\u20134.30) g\/dL, p &lt; 0.01), total cholesterol (158 (133\u2013196) vs. 180 (148\u2013206) mg\/dL, p &lt; 0.01), and creatinine (6.34 (5.08\u20137.33) vs. 7.12 (5.70\u20138.51) mg\/dL, p &lt; 0.05). SGA score (12.0 (10.0\u201315.0) vs. 11.0 (9.0\u201313.0) points, p &lt; 0.001), BMI (27.9 (24.4\u201331.8) vs. 25.6 (22.9\u201328.8) kg\/m2, p &lt; 0.001), fat tissue index (15.0 (11.4\u201319.6) vs. 12.8 (9.6\u201316.0) %, p &lt; 0.001), and overhydration (2.1 (1.2\u20134.1) vs. 1.8 (0.7, 2.7) L, p &lt; 0.001) were higher in the DM group. Increased morbidity, reflected in the CCI and mortality\u2014both all-cause and cardiovascular\u2014were observed in DM patients. Conclusions: Hemodialysis recipients with DM experience overnutrition with a paradoxically higher predisposition to PEW, expressed by a higher SGA score and lower serum markers of nutrition. This population is also more comorbid and is at higher risk of death, including from cardiovascular causes.<\/jats:p>","DOI":"10.3390\/nu14020247","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T20:21:56Z","timestamp":1641759716000},"page":"247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Can Overnutrition Lead to Wasting?\u2014The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5123-9228","authenticated-orcid":false,"given":"Krzysztof","family":"Hoppe","sequence":"first","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Schwermer","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miko\u0142aj","family":"Dopiera\u0142a","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2116-4384","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Ka\u0142u\u017cna","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4448-8768","authenticated-orcid":false,"given":"Jadzia Tin-Tsen","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Oko","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6237-0814","authenticated-orcid":false,"given":"Krzysztof","family":"Pawlaczyk","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"A6","DOI":"10.1053\/j.ajkd.2019.09.003","article-title":"US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States","volume":"75","author":"Saran","year":"2019","journal-title":"Am. 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