scholarly journals Association of Growth Differentiation Factor 15 with Mortality in a Prospective Hemodialysis Cohort

2017 ◽  
Vol 7 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Amy S. You ◽  
Kamyar Kalantar-Zadeh ◽  
Lorena Lerner ◽  
Tracy Nakata ◽  
Nancy Lopez ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Risk ◽  
Hemodialysis Patients ◽  
Case Mix ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Protein Energy ◽  
Dialysis Vintage

Background/Aims: Cardiovascular disease and protein-energy wasting are among the strongest predictors of the high mortality of dialysis patients. In the general population, the novel cardiovascular and wasting biomarker, growth differentiation factor 15 (GDF15), is associated with decreased survival. However, little is known about GDF15 in dialysis patients. Methods: Among prevalent hemodialysis patients participating in a prospective study (October 2011 to August 2015), we examined the association of baseline GDF15 levels with all-cause mortality using unadjusted and case mix-adjusted death hazard ratios (HRs) that controlled for age, sex, race, ethnicity, diabetes, and dialysis vintage. Results: The mean age ± SD of the 203 patients included in the study was 53.2 ± 14.5 years, and the cohort included 41% females, 34% African-Americans, and 48% Hispanics. GDF15 levels (mean ± SD 5.94 ± 3.90 ng/mL; range 1.58-39.8 ng/mL) were higher among older patients and were inversely associated with serum creatinine concentrations as a surrogate for muscle mass. Each 1.0 ng/mL increase in GDF15 was associated with an approximately 17-18% higher mortality risk in the unadjusted and case mix models (p < 0.05). Increments of about 1 SD (a 4.0 ng/mL increase in GDF15) were associated with a nearly 2-fold higher death risk. The highest GDF15 tertile was associated with higher mortality risk (reference: lowest tertile): the HRs (95% CI) were 3.19 (1.35-7.55) and 2.45 (1.00-6.00) in the unadjusted and the case mix-adjusted model, respectively. These incremental death trends were confirmed in cubic spline models. Conclusion: Higher circulating GDF15 levels are associated with higher mortality risk in hemodialysis patients. Future studies are needed to determine whether GDF15 may represent a novel therapeutic target for cardiovascular disease, wasting, and death in this population.

Protein-Energy Wasting and Mortality Risk Prediction Among Peritoneal Dialysis Patients

2021 ◽  
Author(s):  
Piyawan Kittiskulnam ◽  
Piyatida Chuengsaman ◽  
Talerngsak Kanjanabuch ◽  
Sirarat Katesomboon ◽  
Somkanya Tungsanga ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Risk Prediction ◽  
Mortality Risk ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy

scholarly journals Excess mortality due to interaction between protein-energy wasting, inflammation and cardiovascular disease in chronic dialysis patients

2008 ◽  
Vol 23 (9) ◽  
pp. 2957-2964 ◽  
Author(s):  
R. de Mutsert ◽  
D. C. Grootendorst ◽  
J. Axelsson ◽  
E. W. Boeschoten ◽  
R. T. Krediet ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Excess Mortality ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy

scholarly journals NT-proBNP, Cardiometabolic Risk Factors, and Nutritional Status in Hemodialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Jacques Ducros ◽  
Laurent Larifla ◽  
Henri Merault ◽  
Lydia Foucan
Keyword(s):  
Nutritional Status ◽  
Cross Sectional Study ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Wasting Syndrome ◽  
Protein Energy ◽  
Catabolic Rate ◽  
Dialysis Vintage

Background.We aimed to evaluate the association between NT-proBNP and malnutrition in HD patients while taking into account the four established categories of parameters for diagnosis of protein energy wasting (PEW).Methods. A cross-sectional study was performed in Afro-Caribbean dialysis patients. One component in each of the 4 categories for the wasting syndrome was retained: serum albumin ≤ 38 g/L, BMI ≤ 23 Kg/m2, serum creatinine ≤ 818 µmol/L, and normalized protein catabolic rate (nPCR) ≤ 0.8 g/kg/day. NT-proBNP was assessed using a chemiluminescence immunoassay. Two multivariate logistic regression models were performed to determine the parameters associated with high NT-proBNP concentrations.Results.In 207 HD patients, 16.9% had PEW (at least three components). LVEF lower than 60% was found in 13.8% of patients. NT-proBNP levels ranged from 125 to 33144 pg/mL. In model 1, high levels of NT-proBNP (≥6243 pg/mL) were independently associated with PEW OR 14.2 (3.25–62.4), male gender 2.80 (1.22–6.57), hsCRP > 5 mg/L 3.90 (1.77–8.57), and dialysis vintage > 3 years 3.84 (1.35–10.8). In model 2, LVEF OR was 0.93 (0.88–0.98). NT-proBNP concentrations were significantly higher when the PEW component number was higher.Conclusion.In dialysis patients, high NT-proBNP levels must draw attention to cardiac function but also to nutritional status.

Comparison of novel risk factors for cardiovascular disease between hemodialysis patients with and without protein-energy wasting

2014 ◽  
Vol 46 (10) ◽  
pp. 2015-2020 ◽  
Author(s):  
Hadi Tabibi ◽  
Atefeh As’habi ◽  
Mitra Mahdavi-Mazdeh ◽  
Mehdi Hedayati ◽  
Behnaz Nozary-Heshmati
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Hemodialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Novel Risk Factors

scholarly journals Relationship between Vascular Calcification, Protein-Energy Wasting Syndrome, and Sarcopenia in Maintenance Automated Peritoneal Dialysis

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 666
Author(s):  
Gustavo Leal-Alegre ◽  
Claudia Lerma ◽  
Gabriela Leal-Escobar ◽  
Bernardo Moguel-González ◽  
Karen Belén Martínez-Vázquez ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Vascular Calcification ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Wasting Syndrome ◽  
Protein Energy ◽  
Inflammation Score

Vascular calcifications affect 80% to 90% of chronic kidney disease patients and are a predictive factor of cardiovascular mortality. Sarcopenia and protein-energy wasting syndrome are also associated with mortality. The aim was to assess the relationship between vascular calcification, sarcopenia, and protein-energy wasting syndrome (PEW) in automated peritoneal dialysis patients. Fifty-one maintenance automated peritoneal dialysis patients were included (27 were male, mean age 39 ± 14 years). Vascular calcification was assessed based on abdomen, pelvis, and hand radiographs. Sarcopenia was assessed with bioimpedance analysis and a hand grip strength test. The Malnutrition–Inflammation Score and the presence of PEW were also assessed. Vascular calcification was present in 21 patients (41.2%). Univariate logistic regression analysis showed that age (p = 0.001), Malnutrition–Inflammation Score (p = 0.022), PEW (p = 0.049), sarcopenia (p = 0.048), and diabetes (p = 0.010) were associated with vascular calcification. Multivariate logistic regression analysis showed that age (p = 0.006) was the only variable associated independently with vascular calcification. In conclusion, there is association between vascular calcification, PEW, and sarcopenia in patients with maintenance automated peritoneal dialysis. These associations are not independent of age. This demonstrates the importance of nutritional status in the prevention of vascular calcification.

scholarly journals The Diagnosis of Protein Energy Wasting in Chronic Peritoneal Dialysis Patients Is Influenced by the Method of Calculating Muscle Mass. A Prospective, Multicenter Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Cristina Techy Roth-Stefanski ◽  
Naiane Rodrigues de Almeida ◽  
Gilson Biagini ◽  
Natália K. Scatone ◽  
Fabiana B. Nerbass ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Muscle Mass ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Multifrequency Bioimpedance ◽  
Study Population ◽  
The Mean ◽  
Main Factor

Objective: To analyze the concordance and agreement between bioimpedance spectroscopy (BIS) and anthropometry for the diagnosis of protein energy wasting (PEW) in chronic peritoneal dialysis patients.Methods: Prospective, multi-center, observational study using multifrequency bioimpedance device (Body Composition Monitor -BCM®- Fresenius Medical Care) and anthropometry for the diagnosis of PEW as recommended by the International Society of Renal Nutrition and Metabolism (ISRNM). Cohen's kappa was the main test used to analyze concordance and a Bland-Altmann curve was built to evaluate the agreement between both methods.Results: We included 137 patients from three PD clinics. The mean age of the study population was 57.7 ± 14.9, 47.8% had diabetes, and 52.2% were male. We calculated the scores for PEW diagnosis at 3 and 6 months after the first collection (T3 and T6) and on average 40% of the study population were diagnosed with PEW. The concordance in the diagnosis of PEW was only moderate between anthropometry and BIS at both T3 and T6. The main factor responsible for our results was a low to moderate correlation for muscle mass in kilograms, with an r-squared (R2) of 0.35. The agreement was poor, with a difference of more than 10 kg of muscle mass on average and with more than a quarter of all cases beyond the limits of agreements.Conclusion: Current diagnosis of PEW may differ depending on the tools used to measure muscle mass in peritoneal dialysis patients.

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