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A simple protein-energy wasting score for survival prediction of maintenance hemodialysis patients

Published on Dec 1, 2015in Renal Replacement Therapy
· DOI :10.1186/s41100-015-0012-0
Sonomi Kobayashi1
Estimated H-index: 1
,
Keiko Suzuki4
Estimated H-index: 4
+ 2 AuthorsKosaku Nitta38
Estimated H-index: 38
Abstract
Background The nutritional status of patients on maintenance hemodialysis (MHD) is a strong predictor of their survival. We assessed the reliability of a protein-energy wasting (PEW) score as a predictor of the survival of Japanese MHD patients.
  • References (35)
  • Citations (2)
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References35
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Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into...
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A nationwide statistical survey of 4279 dialysis facilities was conducted at the end of 2012, among which 4238 responded (99.0%). The number of new dialysis patients was 38 055 in 2012. Since 2008, the number of new dialysis patients has remained almost the same without any marked increase or decrease. The number of dialysis patients who died in 2012 was 30 710; a slight decrease from 2011 (30 743). The dialysis patient population has been growing every year in Japan; it was 310 007 at the end o...
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#2Guillaume JeanH-Index: 21
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Objective: Nutritional status is a powerful predictor of survival in maintenance hemodialysis patients but remains challenging to assess. We defined a new Protein Energy Wasting (PEW) score based on the nomenclature proposed by the International Society of Renal Nutrition and Metabolism in 2008. Design and Methods: This score, graded from 0 (worse) to 4 (best) was derived from 4 body nutrition compartments: serum albumin, body mass index, a normalized serum creatinine value, and protein intake a...
31 CitationsSource
#1Lilia R. Lukowsky (UCLA: University of California, Los Angeles)H-Index: 11
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Last. Kamyar Kalantar-Zadeh (UCLA: University of California, Los Angeles)H-Index: 96
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Purpose Low serum albumin concentration and low dietary protein intake are associated with protein-energy wasting (PEW) and higher mortality in maintenance hemodialysis patients. The role of these nutritional markers is less clear in clinical outcomes of the first several months of dialysis therapy, where mortality is exceptionally high.
23 CitationsSource
#1Csaba P. Kovesdy (UVA: University of Virginia)H-Index: 70
#2Kamyar Kalantar-Zadeh (UCLA: University of California, Los Angeles)H-Index: 96
Uremic malnutrition, also known as protein-energy wasting (PEW), is a common phenomenon in maintenance dialysis patients and a risk factor for poor clinical outcomes including worse quality of life and increased hospitalization and mortality. The paradoxical association between traditional cardiovascular risk factors and better outcomes in dialysis patients also referred to as “reverse epidemiology”, is a good example of the powerful effect-modifying impact of the nutritional status in this popu...
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#2G. Ardine de Wit (UU: Utrecht University)H-Index: 30
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BACKGROUND: Protein-energy wasting is tightly associated with mortality in haemodialysis patients. An expert panel of the International Society of Renal Nutrition and Metabolism (ISRNM) has published a consensus on the parameters that define protein-energy nutritional status and posed the question, 'which scoring system most effectively predicts outcome?' The aim of our study was therefore to develop a composite score of protein-energy nutritional status (cPENS) and to assess its prediction of a...
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Ghrelin abnormalities contribute to anorexia, inflammation, and cardiovascular risk in hemodialysis patients, leading to worse outcome. However, ghrelin levels are influenced by the nutritional status of the individual. We hypothesized that the consequences of ghrelin alterations in hemodialysis patients are context sensitive and dependent on the presence of protein-energy wasting (PEW). In this cross-sectional study of 217 prevalent hemodialysis patients followed for 31 months, we measured ghre...
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Last. Carol D. Ryff (UW: University of Wisconsin-Madison)H-Index: 68
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The pleiotropic cytokine, interleukin-6 (IL-6), has emerged as a key factor in the biology of aging and the physiology of inflammation. Yet much of what we know about the normal functioning of IL-6 has been generated primarily from research on European populations and Americans of European descent. Our analyses compared IL-6 levels in 382 middle-aged and older Japanese to the values found in 1209 Caucasian- and African–Americans from the Midlife in the United States survey (MIDUS). Across the li...
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#1Noël Cano (INRA: Institut national de la recherche agronomique)H-Index: 33
#2Anne-Elisabeth HengH-Index: 14
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Chronic organ failures, including chronic kidney disease, cardiac failure, and chronic pulmonary disease, share a common phenotype which is characterized by a high prevalence of anorexia, inflammation, oxidative stress, insulin resistance, hypogonadism, and anemia. Because of the systemic dimension of organ failure, such a phenotype results in a decrease in body mass, in addition to alterations of body composition and abnormal muscle structure, metabolism, and performance. The response of both p...
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Many patients with chronic kidney disease (CKD), particularly those with stage 5 CKD, have protein wasting. The degree to which increased morbidity and mortality seen in these patients is due to protein depletion rather than to the often accompanying comorbidity is not clear. High protein diets lead to the accumulation of metabolites of protein that are potentially toxic. The MDRD Study, which investigated the effects of three levels of dietary protein and phosphorus intakes and two blood pressu...
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#1Ayako HasegawaH-Index: 1
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Background The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been shown to be a predictor of cardiovascular (CV) outcomes in the general population. The aim of this study was to determine whether the TG/HDL-C ratio is a predictor of CV events and all-cause mortality in maintenance hemodialysis (MHD) patients.
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