Interactions Between Malnutrition, Inflammation, and Fluid Overload and Their Associations With Survival in Prevalent Hemodialysis Patients

Dekker, Marijke; Konings, Constantijn; Canaud, Bernard; Sande, Frank M. van der; Stuard, Stefano; Raimann, Jochen G.; Öztürk, Elife; Usvyat, Len; Kotanko, Peter; Kooman, Jeroen P.

doi:10.1053/j.jrn.2018.06.005

Cited by 46 publications

(31 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, there are important arguments for a clustering of risk factors over different domains, which includes FO as an important novel risk factor. Furthermore, there also appears to be a clustering of abnormalities including those involved in the MIA syndrome with FO, although the relative contribution of abnormalities in the different risk domains might fluctuate between patients and over time …”

Section: Association Of Abnormalities In Body Composition With Other contrasting

confidence: 74%

“…Although in our study, the association between low LTI and mortality was highly apparent in combination with FO and/or inflammation, the association lost significance when corrected for other risk domains . However, in the study of Vega et al, a low LTI added independent prognostic information for risk of mortality, whereas in the study of Castellano et al, a low LTI remained predictive for mortality after adjustment for FO, serum albumin, and the Charlson comorbidity index .…”

Section: Association Of Abnormalities In Body Composition With Other mentioning

confidence: 82%

“…Recently, we explored the association between LTM, inflammation, and FO. In a cohort of 8883 European prevalent dialysis patients, predialytic FO was more pronounced in patients with LTI < 10th percentile, and highest in the subgroup with the combined presence of LTI < 10th percentile and inflammation, defined as a high sensitive CRP (hsCRP) level above 6 mg/L . In 40% of this entire cohort, a low LTI was present in combination with either FO and/or inflammation, whereas in only 6.5% of patients, a low LTI was observed as an isolated phenomenon.…”

Section: Association Of Abnormalities In Body Composition With Other mentioning

confidence: 99%

See 2 more Smart Citations

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

Broers

Canaud

Dekker

et al. 2020

Hemodialysis International

Self Cite

View full text Add to dashboard Cite

Bioimpedance spectroscopy (BIS) is an easily applicable tool to assess body composition. The three compartment model BIS (3C BIS) conventionally expresses body composition as lean tissue index (LTI) (lean tissue mass [LTM]/height in meters squared) and fat tissue index (FTI) (adipose tissue mass/ height in meters squared), and a virtual compartment reflecting fluid overload (FO). It has been studied extensively in relation to diagnosis and treatment guidance of fluid status disorders in patients with advanced-stage or end-stage renal disease. It is the aim of this article to provide a narrative review on the relevance of 3C BIS in the nutritional assessment in this population. At a population level, LTI decreases after the start of hemodialysis, whereas FTI increases. LTI below the 10th percentile is a consistent predictor of outcome whereas a low FTI is predominantly associated with outcome when combined with a low LTI. Recent research also showed the connection between low LTI, inflammation, and FO, which are cumulatively associated with an increased mortality risk. However, studies toward nutritional interventions based on BIS data are still lacking in this population. In conclusion, 3C BIS, by disentangling the components of body mass index, has contributed to our understanding of the relevance of abnormalities in different body compartments in chronic kidney disease patients, and appears to be a valuable prognostic tool, at least at a population level. Studies assessing the effect of BIS guided nutritional intervention could further support its use in the daily clinical care for renal patients.

show abstract

Section: Association Of Abnormalities In Body Composition With Other contrasting

confidence: 74%

Section: Association Of Abnormalities In Body Composition With Other mentioning

confidence: 82%

Section: Association Of Abnormalities In Body Composition With Other mentioning

confidence: 99%

See 1 more Smart Citation

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

Broers

Canaud

Dekker

et al. 2020

Hemodialysis International

Self Cite

View full text Add to dashboard Cite

show abstract

“…(i) A direct effect of PEW on the level of NT-proBNP by affecting ventricular remodeling in HD patients has been suggested [15]. (ii) Complex interactions between NT-proBNP, malnutrition, inflammation, and fluid overload have been reported in HD patients [17,49,50]. In addition, bioimpedance results affected by fluid overload can also be affected by malnutrition (iii) Several parameters among 4 established categories (body mass and composition, muscle mass, biochemical criteria, and dietary intakes) for the definition of PEW according to ISRNM are separately associated with NT-proBNP.…”

Section: Hypotheses To Explain the Relation Between Nt-probnp And Promentioning

confidence: 99%

N-terminal Pro-B-Type Natriuretic Peptide and Malnutrition in Patients on Hemodialysis

Larifla

Merault²,

Galantine³

et al. 2020

International Journal of Nephrology

View full text Add to dashboard Cite

Natriuretic peptides, brain natriuretic peptide (BNP), and N-terminal probrain natriuretic peptide (NT-proBNP) are mainly known as diagnostic markers for heart failure with high diagnostic and prognostic values in the general population. In patients who are undergoing hemodialysis (HD), changes in NT-proBNP can be related to noncardiac problems such as fluid overload, inflammation, or malnutrition and can also be influenced by the dialysis characteristics. The current review aimed to summarize findings from studies on the association between NT-proBNP and malnutrition in HD patients. Articles published after 2009 and over a ten-year period were considered for inclusion. We first briefly discuss the traditional functions of NT-proBNP, and after, we describe the functions of this prohormone by focusing on its relation with protein energy wasting (PEW) in HD patients. Mechanisms that could explain these relationships were also discussed. Overall, 7 studies in which the investigation of the relations between NT-proBNP and nutritional status in HD patients were among the main objects were taken into account. NT-proBNP levels correlated with several factors described in the 4 categories of markers indicative of PEW (body mass and composition, muscle mass, biochemical criteria, and dietary intakes) and/or were associated with PEW. Interactions between several parameters could be involved in the association between NT-proBNP and malnutrition with a strong role of weight status. NT-proBNP is elevated in HD patients and is associated with malnutrition. Nevertheless, the prognostic value of NT-proBNP on nutritional status should be evaluated.

show abstract

“…[26][27][28][29] Most studies conducted such evaluations before the hemodialysis session, although Yilmaz et al 29 conducted them after the session, which is consistent with our approach. In hemodialysis patients, overhydration is associated with malnutrition and inflammation, 30 representing a strong predictor of all-cause mortality in this population. [26][27][28] Handgrip strength is significantly and positively correlated with serum Mg levels in men but negatively correlated with overhydration/extracellular water in both men and women.…”

Section: Hypomagnesemia In Hemodialysis Patientsmentioning

confidence: 99%

Relationship of serum magnesium level with body composition and survival in hemodialysis patients

Mizuiri¹,

Nishizawa²,

Yamashita³

et al. 2019

Hemodialysis International

View full text Add to dashboard Cite

Introduction: A relationship between serum magnesium (Mg) and body composition parameters has not been reported in hemodialysis (HD) patients. We aimed to clarify whether serum Mg has any association with body composition parameters, or survival in HD patients.Methods: This study included 215 consecutive maintenance HD patients. Laboratory data collection and postdialysis body composition analysis were performed at baseline. The patients were divided based on baseline serum Mg level tertiles (low, medium, and high Mg groups). Kaplan-Meier survival, logistic regression analyses and Cox proportional hazard analyses were conducted.Findings: Among all patients, the median age and dialysis vintage were 73 (65-81) years and 44 (8-96) months, respectively. The serum Mg levels were < 2.3, 2.3-2.5, and > 2.5 mg/dL for the low (n = 67), middle (n = 76), and high (n = 72) Mg groups, respectively. Compared to other groups, low Mg group showed significantly higher age and C-reactive protein levels, but lower serum albumin, normalized protein catabolic rates and frequency of on-line hemodiafiltration. The low, middle, and high Mg groups differed significantly regarding body cell mass (fat-free mass without bone mineral mass and extracellular water) index (BCMI): [5.6 (4.2-6.8), 6.0 (4.8-8.1), 6.7 (4.9-7.5) kg/m 2 , respectively] and overhydration/extracellular water ratio (OH/ECW) [11.7 (4.5-21.9), 4.8 (1.0-14.1), 8.5 (−0.5-15.0) %, respectively] but not regarding body mass index, lean tissue index, fat tissue index. Hypomagnesemia was significantly associated with BCMI [odds ratio (OR) [95% confidence interval (CI)]: 0.85 [0.73-1.00] and OH/ECW (OR [95% CI]: 1.03 [1.01-1.05]), respectively. Kaplan-Meyer 3-year survival rates were 53.6%, 69.7%, and 71.7% in low, middle, and high Mg groups, respectively. However, hypomagnesemia was not significantly associated with 3-year allcause mortality independent of age, serum albumin and C-reactive protein.Discussion: Hypomagnesemia was associated with lower BCMI, more pronounced OH/ECW and poorer Kaplan-Meier 3-year cumulative survival, but was not an independent risk factor for mortality in HD patients.

show abstract

Interactions Between Malnutrition, Inflammation, and Fluid Overload and Their Associations With Survival in Prevalent Hemodialysis Patients

Cited by 46 publications

References 23 publications

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

N-terminal Pro-B-Type Natriuretic Peptide and Malnutrition in Patients on Hemodialysis

Relationship of serum magnesium level with body composition and survival in hemodialysis patients

Contact Info

Product

Resources

About