Protein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patients.

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dc.contributor.authorHerselman M.
dc.contributor.authorMoosa M.R.
dc.contributor.authorKotze T.J.
dc.contributor.authorKritzinger M.
dc.contributor.authorWuister S.
dc.contributor.authorMostert D.
dc.date.accessioned2011-05-15T16:17:08Z
dc.date.available2011-05-15T16:17:08Z
dc.date.issued2000
dc.description.abstractThis prospective nonintervention single-center study was undertaken to investigate the role of protein-energy malnutrition (PEM) as a risk factor for morbidity in patients on long-term hemodialysis. Thirty-seven patients from the renal unit of Tygerberg Hospital, Tygerberg, South Africa, were studied for a mean period of 26 months. Morbidity was the main outcome and was defined as the number of hospitalizations and days of hospitalization per patient per year. Investigations included 4-monthly determinations of interdialytic protein catabolic rate (PCR), dietary intake of protein and energy, blood levels of albumin and urea, lymphocyte count, adequacy of dialysis (Kt/V), body weight, intradialytic weight loss, fat mass (FM), fat-free mass (FFM), body mass index (BMI), and bone-free arm muscle area (BF-AMA). A PEM composite score was derived from postdialysis serum albumin, BF-AMA, FM, FFM, and BMI. All-cause morbidity as defined by number of hospitalizations (see text for other definitions of morbidity) showed a significant correlation with the mean and baseline PEM score (P <.01), and a negative correlation with predialysis and postdialysis serum albumin (P <.05) and age (P <.05). There was no significant relationship with PCR, percentage intradialytic weight loss, Kt/V, reuse of dialyzer, period on maintenance hemodialysis, sex, race, and type of dialyzer membrane. When "only infection-related" morbidity was considered, the factors that showed a significant correlation were the mean (P <. 001) and baseline PEM score (P <.01), and percentage intradialytic weight loss (P <.01). There was no significant deterioration in the nutritional status of patients followed up for at least 24 months. It is concluded that infection-related morbidity was associated most strongly with the PEM score and the percentage intradialytic weight loss. The results suggest that PEM is one of the important contributing factors to morbidity, possibly via an effect on the immune system and infection.
dc.description.versionArticle
dc.identifier.citationJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
dc.identifier.citation10
dc.identifier.citation1
dc.identifier.issn10512276
dc.identifier.urihttp://hdl.handle.net/10019.1/14089
dc.subjectprotein
dc.subjectserum albumin
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectbody mass
dc.subjectfemale
dc.subjecthospitalization
dc.subjecthuman
dc.subjectkidney disease
dc.subjectmale
dc.subjectmetabolism
dc.subjectmiddle aged
dc.subjectmorbidity
dc.subjectmortality
dc.subjectnutritional status
dc.subjectprospective study
dc.subjectprotein calorie malnutrition
dc.subjectprotein intake
dc.subjectrenal replacement therapy
dc.subjectrisk factor
dc.subjectweight reduction
dc.subjectAdult
dc.subjectAged
dc.subjectBody Mass Index
dc.subjectDietary Proteins
dc.subjectFemale
dc.subjectHospitalization
dc.subjectHumans
dc.subjectKidney Diseases
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMorbidity
dc.subjectNutritional Status
dc.subjectProspective Studies
dc.subjectProtein-Energy Malnutrition
dc.subjectProteins
dc.subjectRenal Dialysis
dc.subjectRisk Factors
dc.subjectSerum Albumin
dc.subjectWeight Loss
dc.titleProtein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patients.
dc.typeArticle
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