Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
| Autor: | F.-L. Velayoudom-Cephise, Laurent Larifla, Cosmin Alecu, Lydia Foucan, Henri Merault, Jacques Ducros |
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| Rok vydání: | 2015 |
| Předmět: |
Protein-energy wasting
medicine.medical_specialty medicine.medical_treatment Afro-Caribbean patients Serum albumin Disease Afro-Caribbean Bioinformatics Internal medicine Diabetes mellitus Medicine Mortality Prospective cohort study Wasting Body mass index Multidisciplinary business.industry Research Protein energy wasting medicine.disease Hemodialysis medicine.symptom business geographic locations |
| Zdroj: | SpringerPlus |
| ISSN: | 2193-1801 |
| Popis: | Background We assessed the prognostic value of protein-energy wasting (PEW) on mortality in Afro-Caribbean MHD patients and analysed how diabetes, cardiovascular disease (CVD) and inflammation modified the predictive power of a severe wasting state. Method A 3-year prospective study was conducted in 216 patients from December 2011. We used four criteria from the nomenclature for PEW proposed by the International Society of Renal Nutrition and Metabolism in 2008: serum albumin 38 g/L, body mass index (BMI) ≤23 kg/m2, serum creatinine ≤818 µmol/L and protein intake assessed by nPCR ≤0.8 g/kg/day. PEW status was categorized according the number of criteria. Cox regression analyses were used. Results Forty deaths (18.5 %) occurred, 97.5 % with a CV cause. Deaths were distributed as follows: 7.4 % in normal nutritional status, 13.2 % in slight wasting (1 PEW criterion), 28 % in moderate wasting (2 criteria) and 50 % in severe wasting (3–4 criteria). Among the PEW markers, low serum albumin (HR 3.18; P = 0.001) and low BMI (HR 1.97; P = 0.034) were the most significant predictors of death. Among the PEW status categories, moderate wasting (HR 3.43; P = 0.021) and severe wasting (HR 6.59; P = 0.001) were significant predictors of death. Diabetes, CVD, and inflammation were all additives in predicting death in association with severe wasting with a strongest HR (7.76; P |
| Databáze: | OpenAIRE |
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