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Predictors of protein-energy wasting in haemodialysis patients: a cross-sectional study.
- Source :
- Journal of Human Nutrition & Dietetics; Feb2016, Vol. 29 Issue 1, p38-47, 10p, 4 Charts, 1 Graph
- Publication Year :
- 2016
-
Abstract
- Background Protein-energy wasting ( PEW) is a highly prevalent condition in haemodialysis patients ( HD). The potential usefulness of nutritional-inflammatory markers in the diagnosis of PEW in chronic kidney disease has not been established completely. We hypothesised that a combination of serum albumin, percentage of mid-arm muscle circumference and standard body weight comprises a better discriminator than either single marker of nutritional status in HD patients. Methods A cross-sectional study was performed in 80 HD patients. Patients were categorised in two groups: well-nourished and PEW. Logistic regression analysis was applied to corroborate the reliability of the three markers of PEW with all the nutritional-inflammatory markers analysed. Results PEW was identified in 52.5% of HD patients. Compared with the well-nourished patients, PEW patients had lower body mass index, serum pre-albumin and body cell mass (all P < 0.001) and higher C-reactive protein (s- CRP) ( P < 0.01). Logistic regression analyses showed that the combination of the three criteria were significantly related with s- CRP >1 mg dL<superscript>−1</superscript>, phase angle <4°, and serum pre-albumin <30 mg dL<superscript>−1</superscript> (all P < 0.05). Other indicators, such as lymphocytes <20% and Charlson comorbidity index, were significantly involved (both P < 0.01). A receiver operating characteristic curve ( area under the curve) of 0.86 ( P < 0.001) was found. Conclusions The combined utilisation of serum albumin, percentage of mid-arm muscle circumference and standard body weight as PEW markers appears to be useful for nutritional-inflammatory status assessment and adds predictive value to the traditional indicators. Larger studies are needed to achieve the reliability of these predictor combinations and their cut-off values in HD patients and other populations. [ABSTRACT FROM AUTHOR]
- Subjects :
- ARM physiology
INFLAMMATION
CHRONIC kidney failure complications
BODY composition
PROTEIN-energy malnutrition
BODY weight
C-reactive protein
CHI-squared test
CONFIDENCE intervals
STATISTICAL correlation
FORECASTING
GOODNESS-of-fit tests
HEMODIALYSIS
HEMODIALYSIS patients
BIOELECTRIC impedance
NUTRITIONAL assessment
PROBABILITY theory
REGRESSION analysis
RESEARCH evaluation
SERUM albumin
SKINFOLD thickness
STATISTICS
T-test (Statistics)
COMORBIDITY
LOGISTIC regression analysis
STATISTICAL power analysis
DATA analysis
STATISTICAL significance
BODY mass index
PREDICTIVE tests
CROSS-sectional method
RECEIVER operating characteristic curves
DATA analysis software
SKELETAL muscle
DESCRIPTIVE statistics
LYMPHOCYTE count
ODDS ratio
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 09523871
- Volume :
- 29
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Human Nutrition & Dietetics
- Publication Type :
- Academic Journal
- Accession number :
- 112507401
- Full Text :
- https://doi.org/10.1111/jhn.12276