Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1 Suppl 2
pubmed:dateCreated
2001-2-22
pubmed:abstractText
Nutritional factors and dialysis adequacy are associated with outcome in hemodialyzed patients, but their relative contribution remains controversial, particularly when dialysis adequacy complies with current recommendations (Kt/V >1.2). Survival, clinical, and nutritional data from a cohort of prevalent 1,610 patients treated by hemodialysis in 20 centers in France have been collected over a 2.5-year period, from January 1996 to July 1998. Data including age, sex, cause of end-stage renal disease (ESRD), clinical outcome, time on dialysis, body mass index (BMI), blood levels of midweek predialysis albumin, prealbumin, and bicarbonate were analyzed. Normalized protein catabolic rate (nPCR), dialysis adequacy parameters, and estimation of lean body mass (LBM) from creatinine generation were computed from pre- and postdialysis urea and creatinine levels. The characteristics of the patients were as follows: age 59.6 +/- 16.5 years, 58.8% males, 11% of diabetics, time on dialysis 63.2 +/- 64.5 m. Weekly dialysis time was 12.18 +/- 1.78 hrs, Kt/V 1.34 +/- 0.34, nPCR 1.10 +/- 0.35 g/kg body weight/day. Albumin concentration was 39.4 +/- 5.3 g/L, prealbumin was 0.33 +/- 0.09 g/L, BMI was 23.0 +/- 4.5 kg/m(2). Overall survival was 89.7% +/- 0.8% and 78.4% +/- 1.1% after 1 and 2 years. In the Cox proportional hazard model, survival was significantly influenced by age, the presence of diabetes, and by concentrations of albumin and prealbumin, but not by other variables, including Kt/V and urea reduction ratio. These results indicate that nutritional protein concentrations were predictive of dialysis outcome, whereas variables reflecting actual body composition and dialysis dose were not. Furthermore, in this well-dialyzed population, dialysis adequacy had no influence on survival. In conclusion, when adequacy targets are met in hemodialyzed patients, survival is mainly dependent on age and nutritional status. Efforts should be focused on the most efficient ways to maintain nutritional status in these patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1523-6838
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
37
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
S81-8
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11158868-Adult, pubmed-meshheading:11158868-Aged, pubmed-meshheading:11158868-Bicarbonates, pubmed-meshheading:11158868-Body Mass Index, pubmed-meshheading:11158868-Cohort Studies, pubmed-meshheading:11158868-Cross-Sectional Studies, pubmed-meshheading:11158868-Female, pubmed-meshheading:11158868-Follow-Up Studies, pubmed-meshheading:11158868-France, pubmed-meshheading:11158868-Hemoglobins, pubmed-meshheading:11158868-Humans, pubmed-meshheading:11158868-Kidney Failure, Chronic, pubmed-meshheading:11158868-Kidney Transplantation, pubmed-meshheading:11158868-Male, pubmed-meshheading:11158868-Middle Aged, pubmed-meshheading:11158868-Nutritional Status, pubmed-meshheading:11158868-Prealbumin, pubmed-meshheading:11158868-Prospective Studies, pubmed-meshheading:11158868-Questionnaires, pubmed-meshheading:11158868-Renal Dialysis, pubmed-meshheading:11158868-Serum Albumin, pubmed-meshheading:11158868-Survival Analysis
pubmed:year
2001
pubmed:articleTitle
Influence of nutritional factors and hemodialysis adequacy on the survival of 1,610 French patients.
pubmed:affiliation
Service de Néphrologie, Hôpital Pellegrin, Bordeaux.
pubmed:publicationType
Journal Article