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

Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation
M J E DekkerJeroen Kooman

Abstract

Predialysis fluid overload (FO) in hemodialysis (HD) patients is associated with an increased risk of death, further increased by the presence of inflammation. Malnutrition is also associated with outcome. Study objectives were, firstly, to investigate if the presence of FO is associated with malnutrition and whether this association is influenced by the presence of inflammation. Second, we assessed the associations of FO, malnutrition, and inflammation with outcome individually and in combination. International cohort study. European patients of the Monitoring Dialysis Outcome Initiative cohort where bioimpedance and C-reactive protein measurements are performed as standard of care. 8883 prevalent HD patients. Body composition, nutritional and inflammation status were assessed during a 3-month baseline period, and all-cause mortality was noted during 1 year follow-up. Malnutrition was defined as a lean tissue index <10th percentile (of age and gender matched healthy controls), FO as a predialysis overhydration >+1.1 L and inflammation as a C-reactive protein > 6.0 mg/L. We used Cox models to investigate the association with outcome. The presence of malnutrition was associated with higher levels of FO, this amount further incre...Continue Reading

Citations

Sep 19, 2019·The Journal of International Medical Research·Yinghui DengWenjing Fu
Dec 13, 2019·BMC Nephrology·Pasquale EspositoTeresa Rampino
Dec 4, 2019·Hemodialysis International·Sonoo MizuiriKenichiro Shigemoto
Jul 10, 2019·Nutrients·Tamara Hew-ButlerMatthew VanSumeren
Mar 4, 2019·Seminars in Dialysis·Richard A Sherman
Mar 25, 2020·International Journal of Nephrology·Jacques DucrosLydia Foucan
Sep 15, 2020·Seminars in Dialysis·Sheetal ChaudhuriLen A Usvyat
May 15, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Fabio PaglialongaGiovanni Montini

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