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Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients.
Nephrology (Carlton). 2017 Jul; 22(7):541-547.N

Abstract

AIM

The International Society of Renal Nutrition and Metabolism (ISRNM) has proposed the diagnostic criteria for protein-energy wasting (PEW). We studied Japanese haemodialysis (HD) patients to verify the diagnostic method, especially with respect to the body mass index (BMI) criterion, as well as the prevalence of PEW and its association with mortality.

METHODS

Japanese patients receiving maintenance HD at three outpatient clinics in Tokyo (n = 210) were enrolled, and prospectively followed-up for 3 years. PEW was diagnosed at baseline, according to the four categories (serum chemistry, body mass, muscle mass and dietary intake) recommended by the ISRNM. For the category of body mass, we select a body mass index (BMI) and set up three thresholds, <18.5, <20.0 and <23.0 kg/m2 , as the diagnostic criterion. The patients who satisfied at least three out of the four categories were diagnosed as PEW.

RESULTS

Protein-energy wasting, when the threshold of a BMI among the diagnostic criteria was defined as <18.5 kg/m2 , was recognized as an independent risk factor for mortality. However, PEW was not recognized as a risk factor when the BMI diagnostic criterion was set at <20.0 or <23.0 kg/m2 . Overall, 14.8% of the patients had PEW. The survival rate of PEW patients was significantly lower than that of non-PEW patients (log rank, P < 0.001).

CONCLUSIONS

The diagnosis algorithm of PEW proposed by an expert panel of the ISRNM strongly associates with mortality. However, given differences in body size in Japan, we suggest to revise the BMI criterion from <23.0 kg/m2 to <18.5 kg/m2 .

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Kanazawa Y
Tokyo Kaseigakuin University, Tokyo, Japan. Organization for Kidney Metabolic Disease Treatment, Tokyo, Japan.
Nakao T
Organization for Kidney Metabolic Disease Treatment, Tokyo, Japan. Bousei Shinjuku Minamiguchi Clinic, Tokyo, Japan.
Murai S
Iidabashi Murai Iin, Tokyo, Japan.
Okada T
Department of Nephrology, Tokyo Medical University, Tokyo, Japan.
Matsumoto H
Nakano Minamiguchi Clinic, Tokyo, Japan.

MeSH

AgedAged, 80 and overAsian PeopleBiomarkersBody CompositionBody Mass IndexEatingFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedNutrition AssessmentNutritional StatusPredictive Value of TestsPrevalenceProspective StudiesProtein-Energy MalnutritionRenal DialysisRenal Insufficiency, ChronicRisk FactorsTime FactorsTokyoTreatment Outcome

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

27165723

Citation

Kanazawa, Yoshie, et al. "Diagnosis and Prevalence of Protein-energy Wasting and Its Association With Mortality in Japanese Haemodialysis Patients." Nephrology (Carlton, Vic.), vol. 22, no. 7, 2017, pp. 541-547.
Kanazawa Y, Nakao T, Murai S, et al. Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients. Nephrology (Carlton). 2017;22(7):541-547.
Kanazawa, Y., Nakao, T., Murai, S., Okada, T., & Matsumoto, H. (2017). Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients. Nephrology (Carlton, Vic.), 22(7), 541-547. https://doi.org/10.1111/nep.12814
Kanazawa Y, et al. Diagnosis and Prevalence of Protein-energy Wasting and Its Association With Mortality in Japanese Haemodialysis Patients. Nephrology (Carlton). 2017;22(7):541-547. PubMed PMID: 27165723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients. AU - Kanazawa,Yoshie, AU - Nakao,Toshiyuki, AU - Murai,Seizo, AU - Okada,Tomonari, AU - Matsumoto,Hiroshi, PY - 2016/02/11/received PY - 2016/05/06/revised PY - 2016/05/08/accepted PY - 2016/5/12/pubmed PY - 2018/5/10/medline PY - 2016/5/12/entrez KW - body mass index KW - haemodialysis KW - protein-energy wasting SP - 541 EP - 547 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 22 IS - 7 N2 - AIM: The International Society of Renal Nutrition and Metabolism (ISRNM) has proposed the diagnostic criteria for protein-energy wasting (PEW). We studied Japanese haemodialysis (HD) patients to verify the diagnostic method, especially with respect to the body mass index (BMI) criterion, as well as the prevalence of PEW and its association with mortality. METHODS: Japanese patients receiving maintenance HD at three outpatient clinics in Tokyo (n = 210) were enrolled, and prospectively followed-up for 3 years. PEW was diagnosed at baseline, according to the four categories (serum chemistry, body mass, muscle mass and dietary intake) recommended by the ISRNM. For the category of body mass, we select a body mass index (BMI) and set up three thresholds, <18.5, <20.0 and <23.0 kg/m2 , as the diagnostic criterion. The patients who satisfied at least three out of the four categories were diagnosed as PEW. RESULTS: Protein-energy wasting, when the threshold of a BMI among the diagnostic criteria was defined as <18.5 kg/m2 , was recognized as an independent risk factor for mortality. However, PEW was not recognized as a risk factor when the BMI diagnostic criterion was set at <20.0 or <23.0 kg/m2 . Overall, 14.8% of the patients had PEW. The survival rate of PEW patients was significantly lower than that of non-PEW patients (log rank, P < 0.001). CONCLUSIONS: The diagnosis algorithm of PEW proposed by an expert panel of the ISRNM strongly associates with mortality. However, given differences in body size in Japan, we suggest to revise the BMI criterion from <23.0 kg/m2 to <18.5 kg/m2 . SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/27165723/Diagnosis_and_prevalence_of_protein_energy_wasting_and_its_association_with_mortality_in_Japanese_haemodialysis_patients_ DB - PRIME DP - Unbound Medicine ER -