Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study

SpringerPlus
Lydia FoucanJacques Ducros

Abstract

We assessed the prognostic value of protein-energy wasting (PEW) on mortality in Afro-Caribbean MHD patients and analysed how diabetes, cardiovascular disease (CVD) and inflammation modified the predictive power of a severe wasting state. A 3-year prospective study was conducted in 216 patients from December 2011. We used four criteria from the nomenclature for PEW proposed by the International Society of Renal Nutrition and Metabolism in 2008: serum albumin 38 g/L, body mass index (BMI) ≤23 kg/m(2), serum creatinine ≤818 µmol/L and protein intake assessed by nPCR ≤0.8 g/kg/day. PEW status was categorized according the number of criteria. Cox regression analyses were used. Forty deaths (18.5 %) occurred, 97.5 % with a CV cause. Deaths were distributed as follows: 7.4 % in normal nutritional status, 13.2 % in slight wasting (1 PEW criterion), 28 % in moderate wasting (2 criteria) and 50 % in severe wasting (3-4 criteria). Among the PEW markers, low serum albumin (HR 3.18; P = 0.001) and low BMI (HR 1.97; P = 0.034) were the most significant predictors of death. Among the PEW status categories, moderate wasting (HR 3.43; P = 0.021) and severe wasting (HR 6.59; P = 0.001) were significant predictors of death. Diabetes, CVD, and in...Continue Reading

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Citations

Feb 18, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Zhen WangRobert H Mak
Oct 28, 2017·International Journal of Nephrology·Jacques DucrosLydia Foucan
Mar 25, 2020·International Journal of Nephrology·Jacques DucrosLydia Foucan
Aug 14, 2021·Clinical Nutrition Research·Zahra SohrabiMarzieh Akbarzadeh

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