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

BACKGROUND: 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. METHOD: A 3-year prospective study was conducted...

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Autores principales: Foucan, Lydia, Merault, Henri, Velayoudom-Cephise, Fritz-Line, Larifla, Laurent, Alecu, Cosmin, Ducros, Jacques
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549366/
https://www.ncbi.nlm.nih.gov/pubmed/26322258
http://dx.doi.org/10.1186/s40064-015-1257-3
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author Foucan, Lydia
Merault, Henri
Velayoudom-Cephise, Fritz-Line
Larifla, Laurent
Alecu, Cosmin
Ducros, Jacques
author_facet Foucan, Lydia
Merault, Henri
Velayoudom-Cephise, Fritz-Line
Larifla, Laurent
Alecu, Cosmin
Ducros, Jacques
author_sort Foucan, Lydia
collection PubMed
description BACKGROUND: 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. METHOD: 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. RESULTS: 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 inflammation were all additives in predicting death in association with severe wasting with a strongest HR (7.76; P < 0.001) for diabetic patients. CONCLUSIONS: The nomenclature for PEW predicts mortality in our Afro-Caribbean MHD patients and help to identify patients at risk of severe wasting to provide adequate nutritional support. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40064-015-1257-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-45493662015-08-28 Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study Foucan, Lydia Merault, Henri Velayoudom-Cephise, Fritz-Line Larifla, Laurent Alecu, Cosmin Ducros, Jacques Springerplus Research BACKGROUND: 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. METHOD: 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. RESULTS: 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 inflammation were all additives in predicting death in association with severe wasting with a strongest HR (7.76; P < 0.001) for diabetic patients. CONCLUSIONS: The nomenclature for PEW predicts mortality in our Afro-Caribbean MHD patients and help to identify patients at risk of severe wasting to provide adequate nutritional support. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40064-015-1257-3) contains supplementary material, which is available to authorized users. Springer International Publishing 2015-08-26 /pmc/articles/PMC4549366/ /pubmed/26322258 http://dx.doi.org/10.1186/s40064-015-1257-3 Text en © Foucan et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Foucan, Lydia
Merault, Henri
Velayoudom-Cephise, Fritz-Line
Larifla, Laurent
Alecu, Cosmin
Ducros, Jacques
Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title_full Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title_fullStr Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title_full_unstemmed Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title_short Impact of protein energy wasting status on survival among Afro-Caribbean hemodialysis patients: a 3-year prospective study
title_sort impact of protein energy wasting status on survival among afro-caribbean hemodialysis patients: a 3-year prospective study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549366/
https://www.ncbi.nlm.nih.gov/pubmed/26322258
http://dx.doi.org/10.1186/s40064-015-1257-3
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