The influence of nutritional status on the prognosis of patients receiving treatment with hemodialysis
https://doi.org/10.24884/1561-6274-2019-23-4-59-64
Abstract
Background. To assess the effect of duration of hemodialysis therapy on the body composition of patients with chronic kidney disease stage 5. To study the cumulative survival of patients receiving chronic hemodialysis therapy, depending on changes in their body composition and nutritional status.
Patients and methods. 84 patients with terminal kidney disease from one hemodialysis center were observed for two years. Diamant-AIST device was used for the evaluation of the compartments' volumes and nutritional status.
Results. Negative correlations between the time on the hemodialysis treatment and studied bioelectrical impedance analysis parameters were observed: correlation with total fluid volume (r=-0,6, p<0,05), fat free mass (r=-0,558, p<0,05), free water volume (r=-0,588, p<0,05), fat mass (r=-0,458, p<0,05), lean body mass (r=-0,564, p<0,05), active cell mass (r=-0,5, p<0,05). There was a statistically significant difference between the cumulative survival with regard to mortality from all causes and cardiovascular events of the patients with high and low values of the fat body mass.
Conclusions. Our study showed that change in the compartment's volumes is associated with the length of hemodialysis treatment. There is a statistically significant difference in survival of patients with low and high free fat mass.
About the Authors
D. M. Krutko
Saint-Petersburg State University
Russian Federation
Russian Federation
Denis M. Krutko – MD, Postgraduate student.
199034, St-Petersburg, Univer-sitetskaya emb. 7-9, Phone: +79523784428
S. O. Mazurenko
Saint-Petersburg State University
Russian Federation
Russian Federation
Sergei O. Mazurenko - MD, PhD, DMedSci.
199034, St-Petersburg, Univer-sitetskaya emb. 7-9, Phone: +79117942845
K. G. Staroselsky
City Hospital №26
Russian Federation
Russian Federation
Konstantin G. Staroselsky – MD.
196247, Saint Petersbur, ul. Kostushko 2, Phone: +79052846301
L. G. Ermolaeva
Saint-Petersburg State University
Russian Federation
Russian Federation
Larisa G. Ermolaeva - MD, PhD, Associate professor.
199034, St-Petersburg, Univer-sitetskaya emb. 7-9, Phone: +79523571935
References
1. Couser WG, Remuzzi G, Mendis S et al. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. KidneyInt 2011;80:1258-1270. doi: 10.1038/ki.2011.368
2. Pippias M, Jager KJ, Kramer A et al. The changing trends and outcomes in renal replacement therapy: Data from the ERA-EDTA registry. Nephrol Dial Transplant 2016;31:831-841. doi: 10.1093/ndt/gfv327
3. Vishnevskiy KA, Belyaev EA, Mironenko AN. Polimorbidnost kak prediktor letalnosti u pacientov, nachodyaschichsya na postoyannoy zamestitelnoy pochechnoy terapii gemodializom. Nephrologia 2015; 19(4): 89-94]
4. Johns TS, Estrella MM, Crews DC et al. Neighborhood Socioeconomic Status, Race, and Mortality in Young Adult Dialysis Patients. JAm Soc Nephrol 2014; 25(11):2649-2657. doi: 10.1681/asn.2013111207
5. Fischer MJ, Hsu JY Lora CM et al. Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. J Am Soc Nephrol 2016;27(11):3488-3497. doi: 10.1681/asn.2015050570
6. Mazurenko SO, Enkin AA, Vasiliev AN. BMD and survival in hemodialysis patients. Osteoporosis International 2013;24(1):147. doi:10.1007/s00198-013-2307-8
7. Reiss AB, Miyawaki N, Moon J et al. CKD, arterial calcification, atherosclerosis and bone health: Inter-relationships and controversies. Atherosclerosis 2018;278:49-59. doi:10.1016/j.atherosclerosis.2018.08.046
8. Gongalves FL, Elias RM, dos Reis LM, et al. Serum sclerostin is an independent predictor of mortality in hemodialysis patients. BMC Nephrol 2014;15:190-197. doi:10.1186/1471-2369-15-190
9. Smirnov AV, Dobronravov VA, Kayukov VA, Esayan AM. Chronicheskaya bolezn pochek: dalneyshee razvitie koncepcii i klassifikacii. Nephrologiya 2007;11(4): 7-17
10. Palmer SC, Maggo JK, Campbell KL et al. Dietary interventions for adults with chronic kidney disease. Cochrane Database Syst Rev 2017;4:CD011998. doi: 10.1002/14651858.CD011998.pub2
11. Scribner BH, Buri R, Caner JE et al. The treatment of chronic uremia by the means of intermittent dialysis: a preliminary report. Trans Am Soc Artif Intern Organs 1960;6:114-122. PMID: 13749429
12. Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63(3):793-808. doi: 10.1046/j.1523-1755.2003.00803.x
13. Kovesdy CP, Anderson JE. Reverse epidemiology in patients with chronic kidney disease who are not yet on dialysis. Semin Dial 2007;20(6):566-569. doi: 10.1111/j.1525-139X.2007.00335.x
14. Lu JL, Kalantar-Zadeh K, Ma JZ et al. Association of Body Mass Index with Outcomes in Patients with CKD . J Am Soc Nephrol 2014;25(9):2088-2096. doi: 10.1681/asn.2013070754
15. Acchiardo SR, Moore LW, Latour PA. Malnutrition as the main factor in morbidity and mortality of hemodialysis patients. Kidney International 1983;24(16):199-203. PMID: 6429404
16. Peev V, Nayer A, Contreras G. Dyslipidemia, malnutrition, inflammation, cardiovascular disease and mortality in chronic kidney disease. Curr Opin Lipidol 2014;25(1):54-60. doi: 10.1097/mol.0000000000000045
17. Schoenfeld PY Henry RR, Laird NM, Roxe DM. Assessment of nutritional status of the national cooperative dialysis study population. Kidney International 1983;23:80-88. PMID: 6345902
18. Stenvinkel P, Alvestrand A. Inflammation in end-stage renal disease: sources, consequences, and therapy. Semin Dial 2002 Sep-Oct;15(5):329-337
19. Qureshi AR, Alvestrand A, Divino-Filho JC et al. Inflammation, Malnutrition, and Cardiac Disease as Predictor of Mortality in Hemodialysis Patients. JASN 2002;13:28-36. PMID: 11792759
20. Amparo FC, Kamimura MA, Molnar MZ et al. Diagnostic validation and prognostic significance of the Malnutrition-Inflammation Score in nondialyzed chronic kidney disease patients. Nephrol Dial Transplant 2015;30(5):821-828. doi: 10.1093/ndt/gfu380
21. Kalantar-Zadeh K, Ikizler TA, Block G et al. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis 2003;42:864-881. PMID: 14582032
22. de Jager DJ, Grootendorst DC, Jager KJ et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA 2009;302(16):1782-1789. doi: 10.1001/jama.2009.1488
23. Fouque D, Vennegoor M, ter Wee P et al. EBPG guideline on nutrition. Nephrol Dial Transplant 2007;22(2):ii45-ii87. doi: 10.1093/ndt/gfm020
24. Levey AS, Schoolwerth AC, Burrows NR et al. Comprehensive public health strategies for preventing the development, progression, and complications of CKD: Report of an expert panel convened by the Centers for Disease Control and Prevention. Am J Kidney 2009;53:522-535. doi: 10.1053/j.ajkd.2008.11.019
25. Yakovenko A, Rumyantsev A, Somova V. Modern approach to the assessment of the component composition of the body in patients on hemodialysis. Doctor 2018; (1): 43-45
26. Yakovenko AA, Rumyantsev ASh, Konyukhov EA et al. Difficulties in screening protein-energy deficiency in patients receiving treatment with programmed hemodialysis. Clinical Nephrology 2018; (3): 25-30 https://dx.doi.org/10.18565/nephrology.2018.3.25-30
27. Wilson F.P. Xie D, Anderson AH et al. Urinary Creatinine Excretion, Bioelectrical Impedance Analysis, and Clinical Outcomes in Patients with CKD: The CRIC Study. CJASN 2014;9(12):2095-2103. doi: 10.2215/cjn.03790414
28. Yakovenko AA, Rumyantsev A.Sh. The prevalence of protein-energy deficiency in patients receiving treatment with programmed hemodialysis. Nephrology and dialysis. 2019. 21 (1): 66-71 DOI: 10.28996/2618-9801-2019-1-66-71
29. Rymarz A, Gibinska J, Zajbt M et al. Low lean tissue mass can be a predictor of one-year survival in hemodialysis patients. Ren Fail 2018;40(1):231-237. doi: 10.1080/0886022x.2018.1456451
30. Marcelli D, Usvyat LA, Kotanko P et al. Body composition and survival in dialysis patients: results from an international cohort study. Clin J Am Soc Nephrol 2015;10(7):1192-1200. doi: 10.2215/cjn.08550814
31. Smirnov AV, Rumyantsev ASh. Rehabilitation of patients on hemodialysis. A guide for doctors. M.: SIMK, 2018: 208
32. Zoccali C, Torino C, Tripepi G, Mallamaci F. Assessment of obesity in chronic kidney disease: what is the best measure? Curr Opin Nephrol Hypertens 2012;21(6):641-646. doi: 10.1097/mnh.0b013e328358a02b
33. Furstenberg A, Davenport A. Comparison of multifrequency bioelectrical impedance analysis and dual-energy X-ray absorptiometry assessments in outpatient hemodialysis patients. Am J Kidney Dis 2011;57(1):123-129. doi: 10.1053/j.ajkd.2010.05.022
Review
For citations:
Krutko D.M., Mazurenko S.O., Staroselsky K.G., Ermolaeva L.G. The influence of nutritional status on the prognosis of patients receiving treatment with hemodialysis. Nephrology (Saint-Petersburg). 2019;23(4):59-64. (In Russ.) https://doi.org/10.24884/1561-6274-2019-23-4-59-64
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