An updated clinical prediction model of protein-energy wasting for hemodialysis patients

Autor: Si Chen, Xiaoyan Ma, Xun Zhou, Yi Wang, WeiWei Liang, Liang Zheng, Xiujuan Zang, Xiaobin Mei, Yinghui Qi, Yan Jiang, Shanbao Zhang, Jinqing Li, Hui Chen, Yingfeng Shi, Yan Hu, Min Tao, Shougang Zhuang, Na Liu
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Nutrition, Vol 9 (2022)
Druh dokumentu: article
ISSN: 2296-861X
DOI: 10.3389/fnut.2022.933745
Popis: Background and aimProtein-energy wasting (PEW) is critically associated with the reduced quality of life and poor prognosis of hemodialysis patients. However, the diagnosis criteria of PEW are complex, characterized by difficulty in estimating dietary intake and assessing muscle mass loss objectively. We performed a cross-sectional study in hemodialysis patients to propose a novel PEW prediction model.Materials and methodsA total of 380 patients who underwent maintenance hemodialysis were enrolled in this cross-sectional study. The data were analyzed with univariate and multivariable logistic regression to identify influencing factors of PEW. The PEW prediction model was presented as a nomogram by using the results of logistic regression. Furthermore, receiver operating characteristic (ROC) and decision curve analysis (DCA) were used to test the prediction and discrimination ability of the novel model.ResultsBinary logistic regression was used to identify four independent influencing factors, namely, sex (P = 0.03), triglycerides (P = 0.009), vitamin D (P = 0.029), and NT-proBNP (P = 0.029). The nomogram was applied to display the value of each influencing factor contributed to PEW. Then, we built a novel prediction model of PEW (model 3) by combining these four independent variables with part of the International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria including albumin, total cholesterol, and BMI, while the ISRNM diagnostic criteria served as model 1 and model 2. ROC analysis of model 3 showed that the area under the curve was 0.851 (95%CI: 0.799–0.904), and there was no significant difference between model 3 and model 1 or model 2 (all P > 0.05). DCA revealed that the novel prediction model resulted in clinical net benefit as well as the other two models.ConclusionIn this research, we proposed a novel PEW prediction model, which could effectively identify PEW in hemodialysis patients and was more convenient and objective than traditional diagnostic criteria.
Databáze: Directory of Open Access Journals