Document Detail


Unintentional weight loss is an independent predictor of mortality in a hemodialysis population.
MedLine Citation:
PMID:  20833072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study investigated common components of classification of nutrition screening risk in the prediction of clinical end-points (mortality and morbidity) in hemodialysis patients over a 3-year period (2005 to 2008).
DESIGN: This was a retrospective cohort study.
SETTING: This study was conducted at a Hemodialysis centre.
PARTICIPANTS: The study included patients on maintenance hemodialysis in June 2005.
INTERVENTION: Assessment of nutrition risk was carried out using components of Protein-Energy Wasting criteria.
MAIN OUTCOME MEASURE: Clinical outcome at the 3-year follow-up (June 2008) was measured as mortality and morbidity (as unplanned hospital admissions). Risk of mortality was investigated independent of comorbidities, age, gender, ethnicity, and dialysis vintage using Cox proportional hazards model.
RESULTS: A total of 217 patients met the inclusion criteria (143 male [66%]; age, 60.5 ± 15.6 years). Patients who lost ≥5% body weight in the 6 months before the study commenced, had a 3-fold (Hazard Ratio = 3.0; 95% confidence interval: 1.2 to 7.5) independent greater risk of death (P = .02). Low serum albumin (<38 g/L) resulted in higher morbidity and mortality; however, this was not statistically significant when adjusted for confounders. Body mass index was only available in 64% (138 of 217) of the cohort at baseline, and was not related to clinical outcome at the 3-year follow-up.
CONCLUSION: Unintentional weight loss is independently predictive of clinical outcome in this cohort of dialysis patients. It is recommended that nutrition screening tools include weight loss as a key component in classification of risk and for prioritizing patient care.
Authors:
Katrina L Campbell; Helen L MacLaughlin
Publication Detail:
Type:  Journal Article     Date:  2010-09-15
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  20     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  414-8     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.
Affiliation:
Nutritional Sciences Division, King's College, London, United Kingdom. Katrina_Campbell@health.qld.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Mass Index
Comorbidity
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / epidemiology*,  mortality*
Male
Malnutrition / metabolism
Middle Aged
Morbidity
Nutritional Status
Proportional Hazards Models
Renal Dialysis / mortality*,  statistics & numerical data*
Retrospective Studies
Serum Albumin / analysis
Weight Loss*
Chemical
Reg. No./Substance:
0/Serum Albumin

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