scholarly journals Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1870
Author(s):  
Ming-Tsun Tsai ◽  
Wei-Cheng Tseng ◽  
Shuo-Ming Ou ◽  
Kuo-Hua Lee ◽  
Chih-Yu Yang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Body Mass ◽  
Inflammatory Markers ◽  
Risk Index ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Fat Free Mass ◽  
Screening Tools ◽  
Composition Analysis ◽  
Nutritional Risk Index

Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 ± 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud’s formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40–0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21–0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients.

scholarly journals Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Feier Song ◽  
Huan Ma ◽  
Shouhong Wang ◽  
Tiehe Qin ◽  
Qing Xu ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Risk Index ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Hospital Death ◽  
Nutritional Screening ◽  
Nutritional Risk Index ◽  
Conut Score

Abstract Background Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality. Methods A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. Results Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. Conclusions Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.

Comparison of the Performance of Existing Nutritional Screening Tools against Subjective Global Assessment in Cirrhotic Patients

2021 ◽  
Vol 104 (8) ◽  
pp. 1301-1308
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Screening Tool ◽  
Risk Index ◽  
Assessment Tools ◽  
Screening Tools ◽  
Subjective Global Assessment ◽  
Nutritional Screening ◽  
Nutritional Risk Index ◽  
Cirrhotic Patients

Background: Malnutrition in cirrhosis has a significant negative impact on morbidity and mortality. There is no agreed gold standard of the screening tool. Study comparing the diagnostic properties of nutritional assessment tools in cirrhotic patients is limited. The Subjective Global Assessment (SGA) is one of the global assessment tools. It is used to assess nutritional status in different patient populations. Objective: To evaluate the diagnostic properties of different nutritional screening tools compared with SGA in cirrhotic patients. Materials and Methods: A cross-sectional study was conducted at the HRH Princess Maha Chakri Sirindhorn Medical Center. All cirrhotic patients were enrolled. The nutritional status was evaluated by the SGA, the Royal Free Hospital Subjective Global Assessment (RFH-SGA), the Royal Free Hospital-Nutritional Prioritizing tool (RFH-NPT), the Liver Disease Undernutrition Screening Tool (LDUST), the Malnutrition Universal Screening Tool (MUST), the Prognostic Nutritional Index (PNI-O), the Nutritional Risk Index (NRI), the Spanish Society of Parenteral, the Enteral Nutrition (SENPE), and the Controlling Nutritional Status (CONUT). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to evaluate RFH-SGA, RFH-NPT, LDUST, MUST, PNI-O, NRI, SENPE, and CONUT compared with SGA. Results: Ninety-four cirrhotic patients were included. The mean age was 60.82 (SD 10.11) years. Patients with cirrhosis Child Turcotte Pugh (CTP) A, B, and C were 62, 21, and 11, respectively. Twenty-five patients (28.7%) were malnourished according to SGA, five with CTP A cirrhosis, twelve with CTP B cirrhosis, and ten with CTP C cirrhosis. The present study also showed that NRI had the highest sensitivity (100%) and LDUST had the highest specificity (94%). Conclusion: NRI is an effective tool with high sensitivity for identifying malnutrition in early stage of cirrhosis. Keywords: Nutritional screening; Cirrhosis; Subjective Global Assessment; SGA; Nutritional Risk Index; NRI

Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status

2021 ◽  
pp. 019459982110045
Author(s):  
Nicolas Saroul ◽  
Mathilde Puechmaille ◽  
Céline Lambert ◽  
Achraf Sayed Hassan ◽  
Julian Biau ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Inflammatory Response ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Risk Index ◽  
Nutritional Risk ◽  
Inflammatory Status ◽  
Nutritional Risk Index

Objectives To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. Study Design Single-center retrospective study of prospectively collected data. Setting Tertiary referral center. Methods Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. Results In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. Conclusion Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.

scholarly journals Association between geriatric nutritional risk index and stroke risk in hemodialysis patients: 10-Years outcome of the Q-Cohort study

2021 ◽  
Vol 323 ◽  
pp. 30-36
Author(s):  
Shoji Tsuneyoshi ◽  
Yuta Matsukuma ◽  
Yasuhiro Kawai ◽  
Hiroto Hiyamuta ◽  
Shunsuke Yamada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Stroke Risk ◽  
Risk Index ◽  
Hemodialysis Patients ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index

QT Prolongation in Dialysis Patients: An Epidemiological Study with a Focus on Malnutrition

2021 ◽  
pp. 1-8
Author(s):  
Masanori Shibata ◽  
Isao Ito ◽  
Hisae Tawada ◽  
Shinkichi Taniguchi
Keyword(s):  
Risk Index ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Serum Levels ◽  
Qt Prolongation ◽  
Fat Free Mass ◽  
Nutritional Risk ◽  
Diabetic Patients ◽  
Qtc Interval ◽  
Nutritional Risk Index

<b><i>Background/Aims:</i></b> QT prolongation is a known risk factor for ventricular fibrillation and ventricular tachycardia. Therefore, more refined management is necessary to reduce sudden cardiac death secondary to such arrhythmias. <b><i>Methods:</i></b> Electrocardiographic findings were reviewed in 224 patients, and the associations of QT prolongation with various clinical parameters were examined, including the nutritional state. Correlations were also examined between QT prolongation and body composition measurements determined by multifrequency bioelectrical impedance analysis. <b><i>Results:</i></b> Prolongation of the corrected QT (QTc) interval over 0.44 s was seen in 140 patients (62.5%). QT prolongation was independent of age and dialysis therapy duration and was more frequent in diabetics (70.1%) than in nondiabetics (54.2%, <i>p</i> = 0.014) and more frequent in women (78.8%) than in men (53.5%, <i>p</i> &#x3c; 0.001). Serum levels of albumin (<i>p</i> &#x3c; 0.001) and Cr (<i>p</i> &#x3c; 0.001) and the Geriatric Nutritional Risk Index (GNRI, <i>p</i> &#x3c; 0.001) were negatively correlated with QTc interval; no significant correlation was noted with total protein, urea nitrogen, or uric acid. Negative correlations with QTc interval were found for BMI(<i>p</i> &#x3c; 0.01), percent total body water (%TBW; <i>p</i> &#x3c; 0.05), and percent intracellular water (%ICW; <i>p</i> &#x3c; 0.01) but not with the percent extracellular water/TBW ratio or edema ratio. The longer the QTc interval, the lower the fat-free mass (FFM; <i>p</i> &#x3c; 0.01) and muscle mass (MM; <i>p</i> &#x3c; 0.01), but there was no significant correlation with percent fat. <b><i>Conclusion:</i></b> These results suggest that QT prolongation is a common complication and is more frequent in women and diabetic patients. The decreases in serum albumin and Cr levels, GNRI, BMI, %TBW, %ICW, FFM, and MM together coincided with malnutrition and thus suggest a close relationship of QT prolongation with malnutrition. Management of QT prolongation may be achieved better in the future by understanding these biochemical and biophysical changes, particularly those regarding malnutrition.

scholarly journals Geriatric nutritional risk index accurately predicts cardiovascular mortality in incident hemodialysis patients

2014 ◽  
Vol 64 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Hiroshi Takahashi ◽  
Yasuhiko Ito ◽  
Hideki Ishii ◽  
Toru Aoyama ◽  
Daisuke Kamoi ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Risk Index ◽  
Hemodialysis Patients ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index

scholarly journals Systemic inflammation and nutritional insufficiency in palliative cancer patients

2021 ◽  
Vol 102 (4) ◽  
pp. 446-452
Author(s):  
O V Kurchenkova ◽  
U V Kharlamova ◽  
A V Vazhenin ◽  
A O Abdalov
Keyword(s):  
Cancer Patients ◽  
Body Mass ◽  
Systemic Inflammation ◽  
Risk Index ◽  
Nutritional Risk ◽  
Albumin Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nutritional Risk Index ◽  
Nutritional Insufficiency

Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.

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