Nutritional parameters and mortality in incident hemodialysis patients

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dc.contributor.author Araújo, Isabel Cristina de [UNIFESP]
dc.contributor.author Kamimura, Maria Ayako [UNIFESP]
dc.contributor.author Draibe, Sergio Antonio [UNIFESP]
dc.contributor.author Canziani, Maria Eugênia Fernandes [UNIFESP]
dc.contributor.author Manfredi, Sílvia Regina [UNIFESP]
dc.contributor.author Avesani, Carla Maria [UNIFESP]
dc.contributor.author Sesso, Ricardo de Castro Cintra [UNIFESP]
dc.contributor.author Cuppari, Lilian [UNIFESP]
dc.date.accessioned 2016-01-24T12:38:13Z
dc.date.available 2016-01-24T12:38:13Z
dc.date.issued 2006-01-01
dc.identifier http://dx.doi.org/10.1053/j.jrn.2005.10.003
dc.identifier.citation Journal of Renal Nutrition. Philadelphia: W B Saunders Co-Elsevier Inc, v. 16, n. 1, p. 27-35, 2006.
dc.identifier.issn 1051-2276
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/28603
dc.description.abstract Objective: To evaluate the impact of nutritional parameters at the time of initiation of hemodialysis (HD) on mortality.Design: Retrospective study.Setting: Dialysis Unit of the Federal University of São Paulo, Oswaldo Ramos Foundation.Patients: Three hundred forty-four incident HD patients (60.5% male, 26% diabetic) with the first nutritional evaluation performed before completing 3 months of onset of HD were included.Methods: the study consisted of baseline measurements of several nutritional parameters (triceps skinfold thickness [TSF], midarm muscle circumference [MAMC], body mass index [BMI], serum albumin, serum creatinine, and protein and energy intake assessed by 3-day food diary) and records of outcome (death) over a period of 10 years.Results: Muscle and/or fat depletion was observed in 51% of the studied patients, according to the percent standard of MAMC and TSF, respectively. Presence of diabetes, age over 60 years, serum albumin < 3.5 g/dL, MAMC adequacy < 90%, protein intake < 1.0 g/kg/d, and energy intake < 25 kcal/kg/d were associated with worse survival. When patients were analyzed according to tertiles of dialysis vintage, BMI >= 25 (calculated as kg/m(2)) had a negative impact on survival only in the highest tertile (> 2.45 years). Patients with BMI < 25 and MAMC adequacy : 90% showed the best survival over the study period, and those with BMI >= 25 but MAMC adequacy < 90% had the worst survival (P = .004). in the multivariate survival analysis adjusting for diabetes, advanced age, and hypoalbuminemia, the reduced MAMC (P = .008) and the low energy intake (P = .03) were independent predictors of death in incident HD patients.Conclusions: Reduced MAMC and low energy intake at the beginning of chronic dialysis are risk factors for mortality. A negative effect of high BMI on survival was associated with reduced MAMC and longer dialysis vintage. (c) 2006 by the National Kidney Foundation, Inc. en
dc.format.extent 27-35
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof Journal of Renal Nutrition
dc.rights Acesso aberto
dc.title Nutritional parameters and mortality in incident hemodialysis patients en
dc.type Artigo
dc.rights.license http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Universidade Federal de São Paulo, Nutr Program, São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Div Nephrol, Nurse Grp, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Nutr Program, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Div Nephrol, Nurse Grp, São Paulo, Brazil
dc.identifier.doi 10.1053/j.jrn.2005.10.003
dc.description.source Web of Science
dc.identifier.wos WOS:000235036200004



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