Cargando…

Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients

Subjective global assessment (SGA) is associated with mortality in end-stage renal disease (ESRD) patients. However, little is known whether improvement or deterioration of nutritional status after dialysis initiation influences the clinical outcome. We aimed to elucidate the association between cha...

Descripción completa

Detalles Bibliográficos
Autores principales: Kwon, Young Eun, Kee, Youn Kyung, Yoon, Chang-Yun, Han, In Mee, Han, Seung Gyu, Park, Kyoung Sook, Lee, Mi Jung, Park, Jung Tak, Han, Seung H., Yoo, Tae-Hyun, Kim, Yong-Lim, Kim, Yon Su, Yang, Chul Woo, Kim, Nam-Ho, Kang, Shin-Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998609/
https://www.ncbi.nlm.nih.gov/pubmed/26886609
http://dx.doi.org/10.1097/MD.0000000000002714
_version_ 1782449971539214336
author Kwon, Young Eun
Kee, Youn Kyung
Yoon, Chang-Yun
Han, In Mee
Han, Seung Gyu
Park, Kyoung Sook
Lee, Mi Jung
Park, Jung Tak
Han, Seung H.
Yoo, Tae-Hyun
Kim, Yong-Lim
Kim, Yon Su
Yang, Chul Woo
Kim, Nam-Ho
Kang, Shin-Wook
author_facet Kwon, Young Eun
Kee, Youn Kyung
Yoon, Chang-Yun
Han, In Mee
Han, Seung Gyu
Park, Kyoung Sook
Lee, Mi Jung
Park, Jung Tak
Han, Seung H.
Yoo, Tae-Hyun
Kim, Yong-Lim
Kim, Yon Su
Yang, Chul Woo
Kim, Nam-Ho
Kang, Shin-Wook
author_sort Kwon, Young Eun
collection PubMed
description Subjective global assessment (SGA) is associated with mortality in end-stage renal disease (ESRD) patients. However, little is known whether improvement or deterioration of nutritional status after dialysis initiation influences the clinical outcome. We aimed to elucidate the association between changes in nutritional status determined by SGA during the first year of dialysis and all-cause mortality in incident ESRD patients. This was a multicenter, prospective cohort study. Incident dialysis patients with available SGA data at both baseline and 12 months after dialysis commencement (n = 914) were analyzed. Nutritional status was defined as well nourished (WN, SGA A) or malnourished (MN, SGA B or C). The patients were divided into 4 groups according to the change in nutritional status between baseline and 12 months after dialysis commencement: group 1, WN to WN; group 2, MN to WN; group 3, WN to MN; and group 4, MN to MN. Cox proportional hazard analysis was performed to clarify the association between changes in nutritional status and mortality. Being in the MN group at 12 months after dialysis initiation, but not at baseline, was a significant risk factor for mortality. There was a significant difference in the 3-year survival rates among the groups (group 1, 92.2%; group 2, 86.0%; group 3, 78.2%; and group 4, 63.5%; log-rank test, P < 0.001). Multivariate Cox regression analysis revealed that the mortality risk was significantly higher in group 3 than in group 1 (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.27–6.03, P = 0.01) whereas the mortality risk was significantly lower in group 2 compared with group 4 (HR 0.35, 95% CI 0.17–0.71, P < 0.01) even after adjustment for confounding factors. Moreover, mortality risk of group 3 was significantly higher than in group 2 (HR 2.89, 95% CI 1.22–6.81, P = 0.02); there was no significant difference between groups 1 and 2. The changes in nutritional status assessed by SGA during the first year of dialysis were associated with all-cause mortality in incident ESRD patients.
format Online
Article
Text
id pubmed-4998609
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-49986092016-09-06 Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients Kwon, Young Eun Kee, Youn Kyung Yoon, Chang-Yun Han, In Mee Han, Seung Gyu Park, Kyoung Sook Lee, Mi Jung Park, Jung Tak Han, Seung H. Yoo, Tae-Hyun Kim, Yong-Lim Kim, Yon Su Yang, Chul Woo Kim, Nam-Ho Kang, Shin-Wook Medicine (Baltimore) 5200 Subjective global assessment (SGA) is associated with mortality in end-stage renal disease (ESRD) patients. However, little is known whether improvement or deterioration of nutritional status after dialysis initiation influences the clinical outcome. We aimed to elucidate the association between changes in nutritional status determined by SGA during the first year of dialysis and all-cause mortality in incident ESRD patients. This was a multicenter, prospective cohort study. Incident dialysis patients with available SGA data at both baseline and 12 months after dialysis commencement (n = 914) were analyzed. Nutritional status was defined as well nourished (WN, SGA A) or malnourished (MN, SGA B or C). The patients were divided into 4 groups according to the change in nutritional status between baseline and 12 months after dialysis commencement: group 1, WN to WN; group 2, MN to WN; group 3, WN to MN; and group 4, MN to MN. Cox proportional hazard analysis was performed to clarify the association between changes in nutritional status and mortality. Being in the MN group at 12 months after dialysis initiation, but not at baseline, was a significant risk factor for mortality. There was a significant difference in the 3-year survival rates among the groups (group 1, 92.2%; group 2, 86.0%; group 3, 78.2%; and group 4, 63.5%; log-rank test, P < 0.001). Multivariate Cox regression analysis revealed that the mortality risk was significantly higher in group 3 than in group 1 (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.27–6.03, P = 0.01) whereas the mortality risk was significantly lower in group 2 compared with group 4 (HR 0.35, 95% CI 0.17–0.71, P < 0.01) even after adjustment for confounding factors. Moreover, mortality risk of group 3 was significantly higher than in group 2 (HR 2.89, 95% CI 1.22–6.81, P = 0.02); there was no significant difference between groups 1 and 2. The changes in nutritional status assessed by SGA during the first year of dialysis were associated with all-cause mortality in incident ESRD patients. Wolters Kluwer Health 2016-02-18 /pmc/articles/PMC4998609/ /pubmed/26886609 http://dx.doi.org/10.1097/MD.0000000000002714 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 5200
Kwon, Young Eun
Kee, Youn Kyung
Yoon, Chang-Yun
Han, In Mee
Han, Seung Gyu
Park, Kyoung Sook
Lee, Mi Jung
Park, Jung Tak
Han, Seung H.
Yoo, Tae-Hyun
Kim, Yong-Lim
Kim, Yon Su
Yang, Chul Woo
Kim, Nam-Ho
Kang, Shin-Wook
Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title_full Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title_fullStr Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title_full_unstemmed Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title_short Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients
title_sort change of nutritional status assessed using subjective global assessment is associated with all-cause mortality in incident dialysis patients
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998609/
https://www.ncbi.nlm.nih.gov/pubmed/26886609
http://dx.doi.org/10.1097/MD.0000000000002714
work_keys_str_mv AT kwonyoungeun changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT keeyounkyung changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT yoonchangyun changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT haninmee changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT hanseunggyu changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT parkkyoungsook changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT leemijung changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT parkjungtak changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT hanseungh changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT yootaehyun changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT kimyonglim changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT kimyonsu changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT yangchulwoo changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT kimnamho changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients
AT kangshinwook changeofnutritionalstatusassessedusingsubjectiveglobalassessmentisassociatedwithallcausemortalityinincidentdialysispatients