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Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation.
J Cyst Fibros. 2014 Mar; 13(2):212-8.JC

Abstract

BACKGROUND

This study retrospectively investigated nutritional status, dietetic intervention and intake in Cystic Fibrosis (CF) patients before and after lung transplantation (LTX).

METHODS

Body Mass Index (BMI), Fat Free Mass Index (FFMI) and nutritional intake were retrieved from 75 out-patients aged 15-53 years. Patients were seen every 3-4 months during the waiting list time (range 0-81 months) and up to 116 months after LTX. Survival was measured in months.

RESULTS

The median BMI at baseline was 19.2 kg/m(2) (range: 15.3 to 28.4 kg/m(2)) with 29 patients (39%) below ≤18.5 kg/m(2). FFMI (measured in 65 patients) had a median of 15.2 kg/m(2) (range: 11.1 to 22.4 kg/m(2)) with 39 patients (60%) ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women). Median energy intake was 2800 kcal, 239 kcal higher than the estimated energy requirement. However, 8 patients consumed ≥500 kcal less than recommended. Protein intake was 104 (range 60-187) g or 1.9 g/kg per day. Despite dietetic intervention with oral nutritional supplements (ONS) (36 patients), tube feeding (12 patients), or both (13 patients), BMI and FFMI hardly improved pre-LTX. LTX was performed in 51 patients (68%); 10 patients died during follow-up, median survival time was 41 months. A BMI ≤18.5 kg/m(2) was more prevalent in patients who died before LTX (6/9) or who died after LTX (4/10) than in patients who were still alive on the waiting list (5/15) or who survived LTX (14/41). Results for FFMI were comparable. From 6-12 months post-LTX, BMI and FFMI markedly improved, especially in underweight patients.

CONCLUSION

A BMI ≤18.5 kg/m(2) and an FFMI ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women) appears to impair survival in LTX candidates with CF. Patients maintained a low body weight before LTX. After LTX weight gain is achieved.

Authors+Show Affiliations

Internal Medicine and Dermatology, Department of Dietetics, University Medical Center Utrecht, The Netherlands; Cystic Fibrosis and Lung Transplantation Center, University Medical Center Utrecht, The Netherlands. Electronic address: F.Hollander@umcutrecht.nl.Division of Human Nutrition, Wageningen University, The Netherlands.Division of Human Nutrition, Wageningen University, The Netherlands.Cystic Fibrosis and Lung Transplantation Center, University Medical Center Utrecht, The Netherlands.Julius Centre for Health Sciences and Primary Care, Department of Public Health, University Medical Center Utrecht, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24041590

Citation

Hollander, F M., et al. "Effects of Nutritional Status and Dietetic Interventions On Survival in Cystic Fibrosis Patients Before and After Lung Transplantation." Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, vol. 13, no. 2, 2014, pp. 212-8.
Hollander FM, van Pierre DD, de Roos NM, et al. Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation. J Cyst Fibros. 2014;13(2):212-8.
Hollander, F. M., van Pierre, D. D., de Roos, N. M., van de Graaf, E. A., & Iestra, J. A. (2014). Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation. Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, 13(2), 212-8. https://doi.org/10.1016/j.jcf.2013.08.009
Hollander FM, et al. Effects of Nutritional Status and Dietetic Interventions On Survival in Cystic Fibrosis Patients Before and After Lung Transplantation. J Cyst Fibros. 2014;13(2):212-8. PubMed PMID: 24041590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation. AU - Hollander,F M, AU - van Pierre,D D, AU - de Roos,N M, AU - van de Graaf,E A, AU - Iestra,J A, Y1 - 2013/09/13/ PY - 2013/02/03/received PY - 2013/08/13/revised PY - 2013/08/22/accepted PY - 2013/9/18/entrez PY - 2013/9/18/pubmed PY - 2014/12/15/medline KW - Body Mass Index KW - Cystic Fibrosis KW - Fat Free Mass KW - Lung transplantation KW - Nutritional intervention KW - Nutritional status SP - 212 EP - 8 JF - Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society JO - J Cyst Fibros VL - 13 IS - 2 N2 - BACKGROUND: This study retrospectively investigated nutritional status, dietetic intervention and intake in Cystic Fibrosis (CF) patients before and after lung transplantation (LTX). METHODS: Body Mass Index (BMI), Fat Free Mass Index (FFMI) and nutritional intake were retrieved from 75 out-patients aged 15-53 years. Patients were seen every 3-4 months during the waiting list time (range 0-81 months) and up to 116 months after LTX. Survival was measured in months. RESULTS: The median BMI at baseline was 19.2 kg/m(2) (range: 15.3 to 28.4 kg/m(2)) with 29 patients (39%) below ≤18.5 kg/m(2). FFMI (measured in 65 patients) had a median of 15.2 kg/m(2) (range: 11.1 to 22.4 kg/m(2)) with 39 patients (60%) ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women). Median energy intake was 2800 kcal, 239 kcal higher than the estimated energy requirement. However, 8 patients consumed ≥500 kcal less than recommended. Protein intake was 104 (range 60-187) g or 1.9 g/kg per day. Despite dietetic intervention with oral nutritional supplements (ONS) (36 patients), tube feeding (12 patients), or both (13 patients), BMI and FFMI hardly improved pre-LTX. LTX was performed in 51 patients (68%); 10 patients died during follow-up, median survival time was 41 months. A BMI ≤18.5 kg/m(2) was more prevalent in patients who died before LTX (6/9) or who died after LTX (4/10) than in patients who were still alive on the waiting list (5/15) or who survived LTX (14/41). Results for FFMI were comparable. From 6-12 months post-LTX, BMI and FFMI markedly improved, especially in underweight patients. CONCLUSION: A BMI ≤18.5 kg/m(2) and an FFMI ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women) appears to impair survival in LTX candidates with CF. Patients maintained a low body weight before LTX. After LTX weight gain is achieved. SN - 1873-5010 UR - https://www.unboundmedicine.com/medline/citation/24041590/Effects_of_nutritional_status_and_dietetic_interventions_on_survival_in_Cystic_Fibrosis_patients_before_and_after_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1569-1993(13)00146-X DB - PRIME DP - Unbound Medicine ER -