Nutritional predictors of mortality in prevalent peritoneal dialysis patients.

Małgorzewicz, Sylwia; Chmielewski, Michael S.; Kaczkan, Małgorzata; Borek, Paulina; Lichodziejewska‐Niemierko, Monika; Rutkowski, Bolesław

doi:10.18388/abp.2015_1070

Cited by 16 publications

(13 citation statements)

References 24 publications

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“…Many studies have found that albumin was a strong predictors for dialysis patients [25,26]. Our study also confirmed that serum albumin, no matter baseline level or time-dependent one, could strongly predict the clinical outcome of hemodialysis patients.…”

Section: Discussionsupporting

confidence: 85%

Clinical Outcome of Twice-Weekly Hemodialysis Patients with Long-Term Dialysis Vintage

Lin

Zhu

et al. 2018

Kidney Blood Press Res

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Background/Aims: Twice-weekly hemodialysis(HD) is prevalent in the developing countries, scarce data are available for this treatment in patients with long-term dialysis vintage. Methods: 106 patients with more than 5 years HD vintage undergoing twice-weekly HD or thrice-weekly HD in a hemodialysis center in Shanghai between December 1, 2013 and December 31, 2013 were enrolled into the cohort study with 3 years follow-up. Kaplan–Meier analysis and Cox proportional hazards models were used to compare patient survival between the two groups. Subgroup analysis of 62 patients more than 10 years HD vintage was also performed according to their different dialysis frequency. Results: Compared with patients on thrice-weekly HD, twice-weekly HD patients had significantly longer HD session time and higher single-pool Kt/V (spKt/V) (session time, 4.59±0.45 vs 4.14±0.31 hours/per session, P< 0.001; spKt/V, 2.12±0.31 vs 1.83±0.30, P< 0.001). Kaplan–Meier survival analysis indicated that the two groups had similar survival (P=0.983). Multivariate Cox regression analysis showed that age and time-dependent serum albumin were predictors of patient mortality. Subgroup analysis of 62 patients more than 10 years HD vintage also indicated that the two groups had similar survival. During the follow-up, 4 patients dropped out from the twice-weekly HD group and transferred to thrice-weekly HD. Conclusion: The similar survival between twice-weekly HD and thrice-weekly HD in patients with long-term dialysis vintage is likely relating to patient selection, individualized treatment for dialysis patients based on clinical features and socioeconomic factors remains a tough task for the clinicians.

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Section: Discussionsupporting

confidence: 85%

Clinical Outcome of Twice-Weekly Hemodialysis Patients with Long-Term Dialysis Vintage

Lin

Zhu

et al. 2018

Kidney Blood Press Res

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“…Similar data have been obtained by researchers from Greece [10]. Malgorzewicz S. and co-authors also determine serum albumin decrease, total cholesterol increase, and a low index of arm muscle circumference are the main NS parameters that have a negative effect on survival [15]. Leinig C. and co-authors in their work have determined that higher body mass index contributes to better survival of patients of dialysis patients' population [11].…”

Section: Completesupporting

confidence: 65%

“…Basing on an examination of 199 PD patients, the authors stated that low serum albumin level, subjective global assessment (SGA), and an insufficient amount of calories taken according to dietary diaries are the main markers of nutritional disorders associated with a veritable increase of mortality and survival rates [11]. Basing on laboratory, functional and anthropometric methods of NS assessment researchers have confirmed the available data concerning the prevalence of ND and their negative impact on the survival of ESRD patients treated with PD [15]. The received data show that the PD treated patients' survival rate is apparently higher in groups with normal NS or a light degree of ND (χ 2 = 22.9; df = 3; p = 0.00004).…”

Section: Completementioning

confidence: 95%

“…The results of this study have once again confirmed that ND is a fairly widespread problem and has a negative impact on the mortality and survival rates for ESRD patients treated with PD. The authors of the work determine the serum albumin decrease, total cholesterol increase and low index of arm muscle circumference as the main NS parameters which affect mortality [15].…”

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confidence: 99%

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Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Shymova

Shifris

Dudar

2019

Ukr. J. Nephrol. and Dial.

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The objective of the work was to study the survival peculiarities ofend-stage renal disease patients treated with continuous ambulatory peritoneal dialysis (CAPD) depending on the nutritional status and informative markers associated with it. Methods. 105 ESRD patients who received CAPD treatment during 2012 - 2017 years at the Kyiv Scientific and Practical Center of Nephrology and Dialysis, which is the clinical base of the State Institution "Institute of Nephrology National Academy of Medical Sciences of Ukraine" were included in the cohort prospective open study. The survival analysis was carried out both in the studied population as a whole and in groups depending on the nutritional status (NS) indicators defined basing on the calculation of the subjective global assessment (SGA) points: the first group (n = 51) consisted of patients without malnutrition, the second group (n = 30) - patients with a mild degree of malnutrition, the third group (n = 13) - patients with a moderate degree of malnutrition, and the fourth group (n = 11) - patients with a severe degree of malnutrition. The survival analysis was conducted both in the groups in compliance with NS, and depending on the informational markers associated with NS, in particular, albumin, body mass index (BMI), residual renal function (RRF). Survival were calculated using the Kaplan-Meier method, and the difference between survival rates was analyzed using the log-rank test and χ². The starting date of peritoneal dialysis treatment was considered as the starting point of the monitoring. The difference was considered to be accurate at p <0.05. Analyzed cases were included till January 7, 2019. The event risk assessment was carried out with the probability of relative risk (RR) values calculating their confidence intervals (95% CI). Results.Forty-three (40.95%) patients died during the current analysis, 17 patients were switched to the hemodialysis (HD), 4 patients had undergone kidney transplantations. Cardiovascular disease was the leading cause of death (41.9%), the second cause of death by frequency was bacterial infections (20.9%). Longer monitoring periods death rate was significantly higher in patients of group with an average (11/84.6% vs 14/27.45%, p <0.0001; RR - 3.08; 95% CI: 1.8 -5.09)and a mild degree of nutritional disorders (ND) (11/84.6% vs 11/36.7%, p = 0.0018, RR - 2.3, 95% CI: 1.36-3.89) compared with normal NS.Similarly, the percentage of died patients with a severe ND degree was significantly higher than those with a normal nutritional status (7/63.6% vs. 14/27.45%, p = 0.0091, RR - 2.31, 95% CI: 1.23 - 4.35). The cumulative survival during the 1- year amounted to 90% of patients for 3 and 5 years - 64% and 41%, respectively. It was found that the survival rate of PD patients is credibly higher in groups with normal NS ormild ND degree than patients of group with a moderate or severe degree of nutritional disorders (χ2 = 22,9; df = 3; p = 0,00004). The cumulative survival for 1 and 3 years was 97%, 98%, 70%, 81% and 76%, 70%, 24%, 36% in groups of patients without nutritional disorder, with mild nutritional disorders, moderate and severe disorders, respectively. The cumulative survival with serum albumin level <35 g/l and ≥ 35 g/l in 1 and 3 years was 73% vs 96% and 37% vs 74%, respectively (p = 0.00005, log-rank test). Similarly, the proportion of survivors with BMI > 24 kg/m2 was apparently higher than those with an indicatorBMI ≤ 24 kg/m2, and it was in 1 and 3 years 94% vs 86% and 79% vs 47%, respectively (p = 0.00321, log-rank test). Veritable differences have been registered in the cumulative frequencies of survivors depending on RRF value: the survival rate was significantly higher among patients with RRF ≥ 5 ml/min/1.73 m² and significantly lower among patients with RRF <2 ml/min/1.73 m2 (χ² = 17.4; df = 2; p = 0.00016). Conclusions.Thus, our studyfound that serum albumin level, BMI and RRF magnitude are the markers for the survival of ESRD patientstreated with PD. Veritable difference between the survival of patients depending on the nutritional status was stated. Three-year cumulative survival with mild degree of malnutrition group was twice as high as in severe nutritional disorders and it was 70% vs 36% (p <0.001). The relative risk of death from all causes increases by 3.1 and 2.32 times for moderate and severe nutritional disorders patients compared to the patients group with normal NS.

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“…Associado ao melhor controle das infecções, estudos que avaliaram e orientaram a adequação do balanço hídrico, da nutrição e especialmente da sobrecarga de glicose, também contribuíram para aumentar a sobrevida dos pacientes em DP (9)(10)(11)(12)(13)(14).…”

Section: Introductionunclassified

Análise do impacto do distúrbio mineral e ósseo na sobrevida dos pacientes com doença renal crônica em diálise peritoneal

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Nutritional predictors of mortality in prevalent peritoneal dialysis patients.

Cited by 16 publications

References 24 publications

Clinical Outcome of Twice-Weekly Hemodialysis Patients with Long-Term Dialysis Vintage

Clinical Outcome of Twice-Weekly Hemodialysis Patients with Long-Term Dialysis Vintage

Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Análise do impacto do distúrbio mineral e ósseo na sobrevida dos pacientes com doença renal crônica em diálise peritoneal

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