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. Methods: The study subjects were 254 MHD patients. PEW score was from 0 (worst; group 1) to 4 (best; group 4) and was derived from four body nutrition compartments: serum albumin, body mass index, a normalized serum creatinine value, and protein intake. The main outcome was all-cause mortality. Results: A total of 26 patients died during the follow-up period of 36 months. The Kaplan-Meier analysis revealed that the group whose score was 0-1 had a significant lower survival rate than the groups with higher (2-4) PEW scores (P < 0.0001). In multivariate analysis, hazard ratios (HRs) were 0.214 (confidence interval (CI) 0.068-0.610, P < 0.005) between group 1 and group 4, 0.176 (0.054-0.510, P < 0.005) between group 2 and group 4, and 0.249 (CI 0.054-0.857) between group 3 and group 4. Conclusions: A new simple PEW score predicts the survival of MHD patients and may help to better identify subgroups of MHD patients with a high mortality rate.

Introduction:The clinical course of hemodialysis patients with COVID-19 still remains unclear.Methods: Thirty-four hemodialysis patients were retrospectively enrolled. Patients were divided according to disease severity, and clinical symptoms and laboratory data at admission were compared. Results:The serum C-reactive protein (CRP) level, D-dimer level, and white blood cell (WBC) count were significantly higher in the group with critical disease than in the group with mild to severe disease (p = 0.005, p = 0.039, and p = 0.045). The serum CRP level exceeded 10 mg/dl within 7 days of clinical onset in all the cases with critical disease. Conclusion:Hemodialysis patients with COVID-19 who have elevated serum CRP and D-dimer levels, and an elevated WBC count at admission and patients with serum CRP levels exceeding 10 mg/dl before day 7 after clinical onset should be carefully monitored for possible progression to critical disease.