Clinical nutrition scores are superior for the prognosis of haemodialysis patients compared to lab markers and bioelectrical impedance

Fiedler, Roman; Jehle, Peter; Osten, B; Dorligschaw, O.; Girndt, Matthias

doi:10.1093/ndt/gfp346

Cited by 64 publications

(76 citation statements)

References 36 publications

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“…Second, we did not assess different approaches to the detection of malnutrition. Clinical nutritional scores have recently been demonstrated to be superior as prognostic indicators in HD patients to laboratory markers, such as serum albumin 3.5 g/dL or CRP 10 mg/L, in a 3-year follow-up study 32) ; however, the regular determination of these scores is time consuming and not practical in maintenance HD patients. Third, the mechanism by which serum albumin 3.8 g/dL contributes to the long-term outcome remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Amemiya

Ogawa

Otsuka

et al. 2011

JAT

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Aim:Although serum albumin and C-reactive protein (CRP) levels and pulse wave velocity (PWV) are known to be associated with the clinical outcome of hemodialysis (HD) patients, it is unknown which of these parameters are more predictive of the long-term mortality of such patients. Methods: We measured biochemical parameters, including serum albumin and CRP, and the PWV of 202 patients on maintenance HD therapy and followed their course for 4 years, and 186 of the patients were enrolled in the current study analyses. We divided the 186 patients into three tertiles according to their serum albumin and CRP levels and PWV values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. Results: Twenty-three (12.4%) patients died during the follow-up period, and the serum albumin of the group that died was significantly lower than in the group that survived, but the CRP levels and PWV were significantly higher in the group that died. The results of Kaplan-Meier analyses revealed a significantly higher risk of all-cause mortality in HD patients with higher CRP based on the results of Cox proportional hazards analyses; however, the serum albumin and PWV values were not associated with all-cause mortality. Conclusion:The results of this study suggest that serum CRP levels are a better mortality predictor than serum albumin or PWV values of chronic HD patients.

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Section: Discussionmentioning

confidence: 99%

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Amemiya

Ogawa

Otsuka

et al. 2011

JAT

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“…However, SGA has been significantly associated with the number, frequency, and length of hospitalization, or risk of first hospitalization event, although these studies had higher hemodialysis duration (in months) and monitoring duration 8,16,25 .…”

Section: Discussionmentioning

confidence: 86%

“…The patients with albumin values <3.8 g/dL had a hospitalization density incidence 2.47 times greater than those with higher levels. Other studies in the United States 4,9,10,24 , Germany 25 , Spain 26 , Australia 8, and Taiwan 10 also reported lower albumin levels in hospitalized hemodialysis patients.…”

Section: Discussionmentioning

confidence: 87%

“…A German study of hemodialysis patients found that patients at nutritional risk according to the Nutritional Risk Screening 2002 experienced a significant increase in hospitalization frequency and length of hospital stay, and that phase angle was only capable of predicting hospitalization frequency 25 . This difference may be explained by the one-year longer monitoring duration of the study.…”

Section: Discussionmentioning

confidence: 99%

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Association between nutritional indicators and risk of hospitalization among hemodialysis patients

et al. 2016

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Objective To verify the ability of nutritional indicators to predict risk of hospitalization in hemodialysis patients. Methods This prospective cohort study was conducted in two hemodialysis units in Southern Brazil. The following nutritional indicators were evaluated: subjective global assessment, malnutrition-inflammation score, nutritional risk screening 2002, percentage of body fat, mid-upper arm muscle circumference, hand grip strength, phase angle, and serum albumin. The association between nutritional indicators and risk of hospitalization over a period of two years was analyzed. Results One hundred thirty-eight patients (55.4±15.2 years, 61.6% men) were evaluated. The cumulative incidence of hospitalization during the study was 48.0% (95%CI=37.9-58.0). Patients hospitalized during the study period had higher body mass index and lower serum albumin than those who were not hospitalized. Based on the other indicators, malnourished patients did not have a significant risk of hospitalization (p>0.05). Serum albumin was the only predictor of hospitalization. Patients with levels <3.8 g/dL had a density ratio for incidence of hospitalization 2.47 times greater than those with higher levels (p=0.003). Gender was a modifier of the effect (p interaction=0.042), with an effect in women of 7.31 (95%CI=2.34-22.9; p=0.001) and in men of 1.37 (95%CI=0.60-3.12; p=0.448). Conclusion Serum albumin was able to predict the risk of hospitalization over a period of two years in female patients undergoing hemodialysis.

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“…Protein-energy wasting (PEW) is another common condition associated with a high cardiovascular morbidity and mortality among hemodialysis (HD) patients [15,16,17,18]. PEW is observed together with chronic microinflammation and atherosclerosis, and uremia is discussed as its main cause [19,20].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency, Mortality, and Hospitalization in Hemodialysis Patients with or without Protein-Energy Wasting

Fiedler¹,

Dorligjav²,

Seibert³

et al. 2011

Nephron Clin Pract

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Background:Vitamin D deficiency and protein-energy wasting (PEW) are highly prevalent in hemodialysis (HD) patients. The goal of our study was to investigate if a lack of vitamin D influences mortality and hospitalization of HD patients with or without PEW. Methods: In 81 chronic HD patients with different nutritional status assessed by the Malnutrition Inflammation Score (MIS), vitamin D deficiency (25-OH-vitamin D₃ levels ≤30 nmol/l or ≤12 ng/ml) was prospectively investigated for its prognostic impact on mortality and hospitalization. Over a 3-year follow-up, all-cause mortality and hospitalization were determined. The predictive value of low vitamin D levels and PEW as well as their combined effect were evaluated using a multivariate Cox regression model. Results: Vitamin D deficiency was frequent in HD patients with and without PEW. It significantly increased mortality rate in HD patients (HR 2.76 (1.33–5.73), p < 0.01), which was aggravated by concomitant PEW (HR 5.88 (2.29–15.09), p < 0.001). The hospitalization rate, however, was not influenced independently by nutritional status. Conclusions: Low 25-OH-vitamin D₃ concentration is an independent predictor for survival, but not for hospitalization of HD patients. It is not merely a malnutrition-associated finding, although a MIS ≧8 further impaired survival prognosis.

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Clinical nutrition scores are superior for the prognosis of haemodialysis patients compared to lab markers and bioelectrical impedance

Cited by 64 publications

References 36 publications

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Association between nutritional indicators and risk of hospitalization among hemodialysis patients

Vitamin D Deficiency, Mortality, and Hospitalization in Hemodialysis Patients with or without Protein-Energy Wasting

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