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Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis.
Nutrients 2017; 9(4)N

Abstract

Protein-energy wasting (PEW) is associated with mortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR), and malnutrition inflammation score (MIS), were measured at baseline. Fifty-three patients died during the study. Survivors had significantly higher nPCR (1.10 ± 0.24 g/kg/day vs. 1.01 ± 0.21 g/kg/day; p = 0.048), energy intake (26.7 ± 5.8 kcal/kg vs. 24.3 ± 4.2 kcal/kg; p = 0.009) and protein intake (0.91 ± 0.21 g/kg vs. 0.82 ± 0.24 g/kg; p = 0.020), and lower MIS (5.2 ± 2.3 vs. 6.1 ± 2.1, p = 0.039). In multivariable analysis, energy intake <25 kcal/kg (HR 1.860, 95% CI 1.018-3.399; p = 0.044) and MIS > 5 (HR 2.146, 95% CI 1.173-3.928; p = 0.013) were independent variables associated with all-cause mortality. These results suggest that higher MIS and lower energy intake are harmful to ESRD patients on maintenance hemodialysis. Optimal energy intake could reduce mortality in these patients.

Authors+Show Affiliations

Department of Dietetics and Nutrition Service, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. sskang@amc.seoul.kr.Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. jwchang@amc.seoul.kr.Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. yongsoon@hanyang.ac.kr.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28420212

Citation

Kang, Shin Sook, et al. "Nutritional Status Predicts 10-Year Mortality in Patients With End-Stage Renal Disease On Hemodialysis." Nutrients, vol. 9, no. 4, 2017.
Kang SS, Chang JW, Park Y. Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis. Nutrients. 2017;9(4).
Kang, S. S., Chang, J. W., & Park, Y. (2017). Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis. Nutrients, 9(4), doi:10.3390/nu9040399.
Kang SS, Chang JW, Park Y. Nutritional Status Predicts 10-Year Mortality in Patients With End-Stage Renal Disease On Hemodialysis. Nutrients. 2017 Apr 18;9(4) PubMed PMID: 28420212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis. AU - Kang,Shin Sook, AU - Chang,Jai Won, AU - Park,Yongsoon, Y1 - 2017/04/18/ PY - 2017/02/06/received PY - 2017/04/12/revised PY - 2017/04/15/accepted PY - 2017/4/20/entrez PY - 2017/4/20/pubmed PY - 2017/9/20/medline KW - hemodialysis KW - mortality KW - nutritional parameters KW - protein energy wasting JF - Nutrients JO - Nutrients VL - 9 IS - 4 N2 - Protein-energy wasting (PEW) is associated with mortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR), and malnutrition inflammation score (MIS), were measured at baseline. Fifty-three patients died during the study. Survivors had significantly higher nPCR (1.10 ± 0.24 g/kg/day vs. 1.01 ± 0.21 g/kg/day; p = 0.048), energy intake (26.7 ± 5.8 kcal/kg vs. 24.3 ± 4.2 kcal/kg; p = 0.009) and protein intake (0.91 ± 0.21 g/kg vs. 0.82 ± 0.24 g/kg; p = 0.020), and lower MIS (5.2 ± 2.3 vs. 6.1 ± 2.1, p = 0.039). In multivariable analysis, energy intake <25 kcal/kg (HR 1.860, 95% CI 1.018-3.399; p = 0.044) and MIS > 5 (HR 2.146, 95% CI 1.173-3.928; p = 0.013) were independent variables associated with all-cause mortality. These results suggest that higher MIS and lower energy intake are harmful to ESRD patients on maintenance hemodialysis. Optimal energy intake could reduce mortality in these patients. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/28420212/Nutritional_Status_Predicts_10_Year_Mortality_in_Patients_with_End_Stage_Renal_Disease_on_Hemodialysis_ L2 - http://www.mdpi.com/resolver?pii=nu9040399 DB - PRIME DP - Unbound Medicine ER -