Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Lopes, Antônio Alberto; Bragg‐Gresham, Jennifer L.; Elder, Stacey J.; Ginsberg, Nancy; Goodkin, David A.; Pifer, Trinh B.; Lameire, Norbert; Marshall, Mark R.; Asano, Yoshihide; Akizawa, Tadao; Pisoni, Ronald L.; Young, Eric W.; Port, Friedrich K.

doi:10.1053/j.jrn.2009.10.002

Cited by 98 publications

(80 citation statements)

References 21 publications

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“…Para esta pesquisa, a média no momento da internação foi de 2,62 ml/dl, no momento da indicação foi de 4,09 ml/dl, no início da hemodiálise de 4,30 ml/dl e ao final do tratamento, 3,02 ml/ dl. A creatinina sérica é um importante marcador do estado nutricional e apresenta relações com a mortalidade de pacientes com enfermidades renais em terapia intensiva (18) . A creatinina manteve-se com valores acima dos considerados de referência em todos os exames.…”

Section: Discussionunclassified

“…O referido estudo apontou a salinização como alternativa recomendada aos pacientes com alto risco para sangramento ou na indisponibilidade do uso do citrato trissódico. O uso de heparina é amplamente empregado, todavia expõe o paciente à anticoagulação sistêmica e à trombocitopenia (18) . Neste estudo, 68,92% dos pacientes desenvolveram LRA em função do choque séptico.…”

Section: Discussionunclassified

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Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Luft¹,

Böes²,

Lazzari³

et al. 2016

Cogitare Enferm.

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RESUMO: Estudo quantitativo, documental, retrospectivo, que objetivou caracterizar o perfil clínico-demográfico e o desfecho de pacientes com insuficiência renal, submetidos à terapia dialítica em uma unidade de terapia intensiva adulto de um hospital geral da região sul do Brasil. Os dados foram coletados no período de janeiro a fevereiro de 2013 e a amostra, constituída por 74 prontuários. Identificou-se prevalência do sexo masculino, média de 63,43 ± 14,73 anos, o motivo clínico foi o mais frequente para internação, com uma ou mais comorbidades associadas. A lesão renal com maior prevalência foi a crônica agudizada, pré-renal. CHRONIC KIDNEY INJURY AT AN INTENSIVE CARE SERVICE: CLINICAL CHARACTERISTICS AND OUTCOMES ABSTRACT:The objective in this quantitative and retrospective documentary study was to characterize the clinical-demographic profile and outcome of kidney failure patients submitted to dialysis therapy at an adult intensive care unit of a general hospital in the South of Brazil. The data were collected between January and February 2013 and the sample consisted of 74 patient histories. The prevalence of men was identified, with a mean age of 63.43 ± 14.73 years, clinical motives were the most frequent cause of hospitalization and one or more associated comorbidities. The most prevalent kidney injury was acute chronic, pre-renal injury. The most recurrent motive for the injury was septic shock. The preferred treatment was conventional hemodialysis using a catheter. The most common outcome was death. The, the identification of risk factors and knowledge about the associated factors supports the rapid identification of problems and the implementation of nursing actions. DESCRIPTORS: Inpatients; Renal insufficiency; Critical care; Renal dialysis. LESIÓN RENAL AGUDA EN UNIDAD DE TRATAMIENTO INTENSIVO: CARACTERÍSTICAS CLÍNICAS Y DESFECHOSRESUMEN: Estudio cuantitativo, documental, retrospectivo, con objeto de caracterizar el perfil clínico-demográfico y el desfecho de pacientes con insuficiencia renal, sometidos a la terapia dialítica en una unidad de terapia intensiva adulto de un hospital general de la región sur de Brasil. Los datos fueron recolectados en enero y febrero del 2013 y la muestra incluyó a 74 archivos. Fue identificada prevalencia del sexo masculino, edad media 63,43 ± 14,73 años, el motivo clínico fue el más frecuente para internación, con una o más comorbilidades asociadas. La lesión renal con mayor prevalencia fue la crónica agudizada, pre-renal. Respecto a los motivos de la lesión, el choque séptico fue el más recurrente. El desfecho más común fue el óbito. Así, la identificación de factores de riesgo y el conocimiento de los factores asociadosapoyan la rápida identificación de problemas y la implementación de acciones de enfermería.

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Section: Discussionunclassified

Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Luft¹,

Böes²,

Lazzari³

et al. 2016

Cogitare Enferm.

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“…9,13 Protein-energy malnutrition is common among HD patients and its prevalence and significance for patient outcomes have been widely investigated. [23][24][25] However, diverse methods have been used for assessment of nutrition in HD patients, which makes it difficult to compare the results. In the present study, the evaluation started with nutritional history performed with a simple screening tool for nutrition in older persons.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive geriatric assessment: comparison of elderly hemodialysis patients and primary care patients

Račić

Petković

Bogićević³

et al. 2015

Renal Failure

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Backgrounds: The quality of life and survival of elderly depend not only on their age but on many social and health factors. In the present study, comprehensive geriatric assessment (CGA) was made in elderly patients on regular hemodialysis (HD) and those without chronic kidney disease recruited in primary health care in order to compare their sociodemographic characteristics, physical health, functional ability and social support. Method: The 106 HD patients and 300 primary care patients aged 70 years and more were studied. Data on sociodemographic characteristics, neurosensory deficits, pain, falls, polypharmacy, basic activities of daily living (ADL) questionnaire, instrumental activities of daily living (IADL) questionnaire were obtained during interview. The Timed Up and Go, Nutritional Health Checklist, Two Question Instrument for depression and Charlson comorbidity index (CCI) were applied. Results: No significant differences were found for age, gender, education level and dwelling between the two groups. A lower percentage of HD patients lived alone when compared with controls. BMI 425 kg/m 2 had 43.4% of HD patients and 49.3% of controls. CCI differed significantly between HD and primary care patients (median: 6 vs. 4) and significantly more HD patients reported depression. No significant difference was found between groups for cognitive dysfunction and ADL, but HD patients had significantly lower IADL scores than controls. The mobility of HD patients was worse; 45.7% of them reported falls in the previous year but only 9.7% from the controls. Conclusions: CGA revealed that HD patients had significantly higher CCI, worse IADL score, mobility and reported more frequent falls, depression and impaired vision than primary care patients.

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“…First, they should intensify pre-dialysis care in order to increase the number of patients starting hemodialysis with an arteriovenous fistula for vascular access, and with an adequate control of hypertension, anemia, mineral metabolism and nutrition. Second, they should try to reduce inflammation and improve the nutritional status of patients on hemodialysis to increase serum albumin [53,54]. Third, they should prevent iron deficiency by repleting iron stores in patients with either absolute (serum ferritin concentration <100 ng) or functional iron deficiency (transferrin saturation <20%) [37].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Cardiovascular Morbidity and Mortality in Spanish Incident Hemodialysis Patients: Two-Year Results from the ANSWER Study

Cuevas

García²,

Martín‐Malo³

et al. 2011

Blood Purif

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Aims: To identify factors associated with cardiovascular (CV) disease in hemodialysis. Methods: Multicenter, prospective, 2-year, observational study in 2,310 incident patients (3,496 patient-years). Multivariate Cox models determined baseline characteristics associated with CV disease. Results: Main factors associated with CV deaths (6.3/100 patient-years) were: high Charlson score (hazard ratio (HR) 3.6; 95% confidence interval (CI) 1.7–7.5 for ≧9 vs. ≤4); low Karnofsky score (KS; HR 2.2; 95% CI 1.5–3.3 for KS ≤50 vs. >70); female gender (HR 1.4; 95% CI 1.1–1.9); catheter access (HR 1.4; 95% CI 1.0–1.9); low (<3.5 g/dl) albumin (HR 2.5; 95% CI 1.8–3.3); ferritin deficiency (HR 1.6; 95% CI 1.2–2.2 for <100 vs. ≧100–500 ng/ml) and low body mass index (BMI; HR 1.9; 95% CI 1.2–3.0 for <20 vs. 20–25). A BMI of ≧30 was a protective factor (HR 0.6; 95% CI 0.4–0.9). Conclusions: There is a high CV risk, especially in older patients with high comorbidity, low BMI, low albumin or iron deficiency. Catheter access increases the CV death risk.

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Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Cited by 98 publications

References 21 publications

Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Comprehensive geriatric assessment: comparison of elderly hemodialysis patients and primary care patients

Risk Factors Associated with Cardiovascular Morbidity and Mortality in Spanish Incident Hemodialysis Patients: Two-Year Results from the ANSWER Study

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