1. Risk of overhydration and low lean tissue index as measured using a body composition monitor in patients on hemodialysis: a systemic review and meta-analysis.
- Author
-
Hwang SD, Lee JH, Lee SW, Kim JK, Kim MJ, and Song JH
- Subjects
- Humans, Kidney Failure, Chronic complications, Kidney Failure, Chronic mortality, Monitoring, Physiologic methods, Prognosis, Proportional Hazards Models, Sarcopenia etiology, Survival Rate, Water-Electrolyte Imbalance etiology, Body Composition, Kidney Failure, Chronic therapy, Renal Dialysis adverse effects, Sarcopenia mortality, Water-Electrolyte Imbalance mortality
- Abstract
Overhydration and sarcopenia, related to an individual's nutritional status, have been associated with increased cardiovascular mortality and poor prognosis in patients on hemodialysis. The purpose of this study was to investigate the prediction of overhydration and sarcopenia on mortality in patients on hemodialysis using a body composition monitor. We conducted a systematic review and meta-analysis using a random-effects model. We searched the Cochrane Central Register, OVID MEDLINE, EMBASE and PubMed databases for all studies published prior to December 9, 2016 and reviewed the reference lists of relevant reviews, registered trials and relevant conference proceedings. The overhydration group (fluid excess, >15% vs. the normohydration group) and the low lean tissue index group ( <10%) were compared with a reference group. Six trials, consisting of 29,469 patients, were included in the pooled analysis. The pooled hazard ratio for overall survival of the overhydration group, compared with the reference normohydration group was 1.798 (95% confidence interval [CI]: 1.53-2.804, p = .001). The hazard ratio for mortality in the low lean tissue index group was 1.533 (95% CI, 1.411-1.644; p = .001) in the random-effects model. The results from the most recent study showed the greatest heterogeneity in the sensitivity analysis. Low lean tissue index and overhydration, measured using a body composition monitor, were associated with a high mortality rate in patients on hemodialysis.
- Published
- 2018
- Full Text
- View/download PDF