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Inflammation and malnutrition as predictors of mortality in patients on hemodialysis.
J Nephrol. 2002 Mar-Apr; 15(2):136-43.JN

Abstract

BACKGROUND

Low albumin and high C-reactive protein (CRP) are significant predictors of mortality in hemodialysis (HD) patients. Although, classically, hypoalbuminemia has been attributed to malnutrition, inflammation can also predict the serum albumin concentration in dialysis patients.

OBJECTIVE

To establish the influence of nutritional status and inflammation on mortality in HD patients.

METHODS

A cross-sectional study was conducted in 64 patients (35 males; 9 diabetics; mean age 64 +/- 12 years), who had been on HD for 64 +/- 58 months. Nutritional status was assessed from estimated protein caloric intake, dietary recall, anthropometric and biochemical parameters, and serum levels of insulin-like growth factor-1 (IGF-1). CRP was used as a marker of inflammation. Comorbidity was measured using a modified M. Charlson index. The dialysis doses (Kt/V) and protein catabolic rate (PCR) were measured and standardized for actual and ideal body weight. The incidence and causes of death were recorded during the two-year follow-up.

RESULTS

During the follow-up period, 18 patients died and 11 were withdrawn from the study after receiving a renal transplant. In multivariante analysis (Cox proportional hazards model), total comorbidity and the levels of CRP and hematocrit (increased) and IGF-1 (decreased) were independent predictors of mortality.

CONCLUSIONS

Inflammation, as measured by CRP, and malnutrition, as measured by IGF-1 levels, are associated with mid-term mortality in HD patients. High hematocrit was an independent risk factor for mortality. Comorbidity, measured by disease and the degree of functional impairment, was a good predictor of mortality.

Authors+Show Affiliations

Servicio de Nefrología, H. General, Segovia, Spain. fdoaude@jazzfree.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12018629

Citation

Fernández-Reyes, María José, et al. "Inflammation and Malnutrition as Predictors of Mortality in Patients On Hemodialysis." Journal of Nephrology, vol. 15, no. 2, 2002, pp. 136-43.
Fernández-Reyes MJ, Alvarez-Ude F, Sánchez R, et al. Inflammation and malnutrition as predictors of mortality in patients on hemodialysis. J Nephrol. 2002;15(2):136-43.
Fernández-Reyes, M. J., Alvarez-Ude, F., Sánchez, R., Mon, C., Iglesias, P., Díez, J. J., & Vázquez, A. (2002). Inflammation and malnutrition as predictors of mortality in patients on hemodialysis. Journal of Nephrology, 15(2), 136-43.
Fernández-Reyes MJ, et al. Inflammation and Malnutrition as Predictors of Mortality in Patients On Hemodialysis. J Nephrol. 2002 Mar-Apr;15(2):136-43. PubMed PMID: 12018629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inflammation and malnutrition as predictors of mortality in patients on hemodialysis. AU - Fernández-Reyes,María José, AU - Alvarez-Ude,Fernando, AU - Sánchez,Rosa, AU - Mon,Carmen, AU - Iglesias,Pedro, AU - Díez,Juan José, AU - Vázquez,Alfonso, PY - 2002/5/23/pubmed PY - 2003/1/8/medline PY - 2002/5/23/entrez SP - 136 EP - 43 JF - Journal of nephrology JO - J Nephrol VL - 15 IS - 2 N2 - BACKGROUND: Low albumin and high C-reactive protein (CRP) are significant predictors of mortality in hemodialysis (HD) patients. Although, classically, hypoalbuminemia has been attributed to malnutrition, inflammation can also predict the serum albumin concentration in dialysis patients. OBJECTIVE: To establish the influence of nutritional status and inflammation on mortality in HD patients. METHODS: A cross-sectional study was conducted in 64 patients (35 males; 9 diabetics; mean age 64 +/- 12 years), who had been on HD for 64 +/- 58 months. Nutritional status was assessed from estimated protein caloric intake, dietary recall, anthropometric and biochemical parameters, and serum levels of insulin-like growth factor-1 (IGF-1). CRP was used as a marker of inflammation. Comorbidity was measured using a modified M. Charlson index. The dialysis doses (Kt/V) and protein catabolic rate (PCR) were measured and standardized for actual and ideal body weight. The incidence and causes of death were recorded during the two-year follow-up. RESULTS: During the follow-up period, 18 patients died and 11 were withdrawn from the study after receiving a renal transplant. In multivariante analysis (Cox proportional hazards model), total comorbidity and the levels of CRP and hematocrit (increased) and IGF-1 (decreased) were independent predictors of mortality. CONCLUSIONS: Inflammation, as measured by CRP, and malnutrition, as measured by IGF-1 levels, are associated with mid-term mortality in HD patients. High hematocrit was an independent risk factor for mortality. Comorbidity, measured by disease and the degree of functional impairment, was a good predictor of mortality. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/12018629/Inflammation_and_malnutrition_as_predictors_of_mortality_in_patients_on_hemodialysis_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -