1
|
Yalçın N, Akman ED, Karcıoğlu O, Allegaert K, Demirkan K, Damadoğlu E, Kalyoncu AF. Effect of Modulator Therapies on Nutritional Risk Index in Adults with Cystic Fibrosis: A Prospective Cohort Study. Nutrients 2024; 16:1811. [PMID: 38931166 PMCID: PMC11206541 DOI: 10.3390/nu16121811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/25/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Modulator therapies improve weight and body mass index (BMI) in cystic fibrosis (CF) patients. We aimed to compare the nutritional risk index (NRI) in adult CF patients receiving modulator (MT) or only non-modulator (conventional) therapies (non-MT). Methods: A single-center prospective cohort study was conducted between June and December 2023. The NRI based on weight gain and albumin was calculated at beginning and end of a 12-week period in both groups. This design was pragmatic, since it was based on individual patient access to MT for 12 weeks. Results: In total, 107 patients were included [mean (SD) age: 23.85 (4.98) years, 54.7% male, 46.7% MT]. In the MT group, mean (SD) weight (kg) and albumin (g/dL) increased significantly [changes: +3.09 (2.74) and +0.17 (0.37); p < 0.001]. In the non-MT group, weight and albumin decreased significantly [changes: -0.99 (1.73) and -0.12 (0.30); p < 0.001]. Compared to the MT group, baseline mean (SD) NRI in the non-MT group was significantly higher [100.65 (11.80) vs. 104.10 (10.10); p = 0.044]. At the end of the 12 weeks, mean (SD) NRI in the MT group was higher than in the non-MT group [104.18 (10.40) vs. 102.58 (12.39); p = 0.145]. In the MT group, the NRI category improved in 22 (44%), and worsened in 3 (6%) patients (p < 0.001). In the non-MT group, the NRI category improved in 2 (3.5%), and worsened in 10 (17.5%) patients (p < 0.001). Conclusions: This is the first study reporting on a positive effect of MT on NRIs, based on weight gain and albumin. Personalized nutrition and routine follow-up of adults with CF based on NRI is recommended prior to MT initiation.
Collapse
Affiliation(s)
- Nadir Yalçın
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06800 Ankara, Türkiye; (N.Y.); (E.D.A.); (K.D.)
| | - Esen Deniz Akman
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06800 Ankara, Türkiye; (N.Y.); (E.D.A.); (K.D.)
| | - Oğuz Karcıoğlu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, 06800 Ankara, Türkiye; (O.K.); (E.D.); (A.F.K.)
| | - Karel Allegaert
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Child and Youth Institute, KU Leuven, 3000 Leuven, Belgium
- Department of Clinical Pharmacy, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06800 Ankara, Türkiye; (N.Y.); (E.D.A.); (K.D.)
| | - Ebru Damadoğlu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, 06800 Ankara, Türkiye; (O.K.); (E.D.); (A.F.K.)
| | - Ali Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, 06800 Ankara, Türkiye; (O.K.); (E.D.); (A.F.K.)
| |
Collapse
|
2
|
Youssef A, Lavergne C, Niglas M, N G Humphreys D, Fulton A, Fathima A, Youssef Y. The Association of Change in Weight During Radiotherapy Treatment With Clinical Outcomes in Patients With Stage I-III Esophageal Cancer. Nutr Cancer 2024; 76:356-363. [PMID: 38356287 DOI: 10.1080/01635581.2024.2316935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
Esophageal carcinoma (EC) and nutritional status are strongly linked due to swallowing disruptions and treatment-related toxicities. Therefore, malnutrition and weight loss (WL) occur in 85% and 79% of EC patients, respectively. WL is frequently associated with worse EC patient outcomes, however, WL during radiation therapy (RT) and EC patient outcomes have not been well established. The purpose of this study is to retrospectively review the association of WL during RT treatment of EC with clinical outcomes. Non-metastatic EC patients from our institution treated between 2010 and 2018, receiving total prescribed dose >40 Gy and aged >18 years, were included. Patients were analyzed by WL during RT, with categories of ≥5% vs. <5% and ≥10% vs. <10%. Patient characteristics and treatment regimens were similar across all WL groups. In univariate analysis, ≥5% and ≥10% WL were significantly associated with both worse overall survival (OS) and progression-free survival (PFS), and ≥10% WL was significantly associated with increased local recurrence. In multivariate analysis, ≥5% WL was significantly associated with OS and PFS. With both ≥5% and ≥10% WL throughout the radiation treatment being detrimental to OS and PFS. The importance of nutritional support in EC patients receiving radiotherapy is further validated.
Collapse
Affiliation(s)
- Andrew Youssef
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Carrie Lavergne
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| | - Mark Niglas
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| | - Deanna N G Humphreys
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| | - Abrielle Fulton
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| | - Ayesha Fathima
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| | - Youssef Youssef
- R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, Oshawa, Ontario, Canada
| |
Collapse
|
3
|
Milaniak I, Tomaszek L, Wiśniowska-Śmiałek S, Górkiewicz-Kot I, Wasilewski G, Kurleto P, Kaleta M, Sobczyk D, Wierzbicki K. Nutritional Risk Assessment and Adverse Events in Patients Undergoing Left Ventricular Assist Device Implantation-A Retrospective Cohort Study Using Hospital Information System. J Clin Med 2023; 12:7181. [PMID: 38002791 PMCID: PMC10672126 DOI: 10.3390/jcm12227181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
Clinical or subclinical malnutrition occurs in 30% to 70% of patients with advanced heart failure and increases the risk of postoperative adverse events. The main objective of this study was to assess the nutritional status of patients prior to left ventricular assist device (LVAD) implantation using different methods of malnutrition assessment and to evaluate the relationship between nutritional status and postoperative adverse events. A retrospective cohort study included 120 patients aged 26-74 years referred for LVAD surgery. Preoperative nutritional status (NRS-2002-Nutritional Risk Score 2002, NRI-Nutritional Risk Index, PNI-Prognostic Nutritional Index; TLC-total lymphocyte count) and postoperative adverse events were assessed. Moderate to severe malnutrition was found in 55.8%, 43.3%, 40.0%, and 20% of all patients, respectively, according to the PNI, NRI, TLC, and NRS-2002 scores. Patients with a TLC < 1200 cells/m3 had a higher risk of postoperative acute renal failure [hazard ratio (HR): 2.5; 95% confidence interval (95% CI): 1.01-6.3] and death during the observation period [HR = 2.1; 95% CI: 1.2-3.5]. Moderate to severe malnutrition was also associated with a significantly increased risk of in-hospital death [for the NRI score, HR = 4.9 (95% CI: 1.1-22.0); for the PNI score, HR = 5.0 (95% CI: 1.1-22.3)]. In conclusion, moderate to severe malnutrition prior to LVAD implantation has been identified as a risk factor for postoperative acute renal failure and mortality. Assessment of nutritional risk may improve patient selection and early initiation of nutritional support.
Collapse
Affiliation(s)
- Irena Milaniak
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland;
| | - Lucyna Tomaszek
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland;
| | - Sylwia Wiśniowska-Śmiałek
- Clinical Department of Heart, Vascular Surgery and Transplantology, Cracow Specialist Hospital Named after St. John Paul II, 31-202 Kraków, Poland; (S.W.-Ś.); (I.G.-K.); (G.W.); (M.K.); (D.S.)
| | - Izabela Górkiewicz-Kot
- Clinical Department of Heart, Vascular Surgery and Transplantology, Cracow Specialist Hospital Named after St. John Paul II, 31-202 Kraków, Poland; (S.W.-Ś.); (I.G.-K.); (G.W.); (M.K.); (D.S.)
| | - Grzegorz Wasilewski
- Clinical Department of Heart, Vascular Surgery and Transplantology, Cracow Specialist Hospital Named after St. John Paul II, 31-202 Kraków, Poland; (S.W.-Ś.); (I.G.-K.); (G.W.); (M.K.); (D.S.)
| | - Paulina Kurleto
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland;
| | - Michał Kaleta
- Clinical Department of Heart, Vascular Surgery and Transplantology, Cracow Specialist Hospital Named after St. John Paul II, 31-202 Kraków, Poland; (S.W.-Ś.); (I.G.-K.); (G.W.); (M.K.); (D.S.)
| | - Dorota Sobczyk
- Clinical Department of Heart, Vascular Surgery and Transplantology, Cracow Specialist Hospital Named after St. John Paul II, 31-202 Kraków, Poland; (S.W.-Ś.); (I.G.-K.); (G.W.); (M.K.); (D.S.)
- Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | | |
Collapse
|
4
|
Kryvoruchko IA, Staikov P, Boyko VV, Sartelli M, Ivanova YV, Honcharov A, Gramatiuk S, Sargsyan K. Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: a retrospective study. BMC Surg 2023; 23:156. [PMID: 37301822 DOI: 10.1186/s12893-023-02062-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Assessment of 'physiological stress levels' and 'nutritional status' before surgery is important for predicting complications and indirect interventions on the pancreas. The aim of this study was to determine neutrophil-lymphocyte ratio (NLR) and nutritional risk index (NRI) indicators before surgery to predict 90-day complications and mortality in a cohort of patients with complicated chronic pancreatitis and cancer of the head of the pancreas. METHODS We evaluated preoperative levels of NLR and NRI among 225 subjects treated at different centres located in three countries. Short-term outcomes included length of hospital stay, postoperative complications, and mortality at 90 days and were appreciated based on NLR and NRI. The level of physiological stress was divided according by the formulas: neutrophil-lymphocyte ratio (NLR) = (neutrophil count, %)/(lymphocyte count, %). The nutritional state of the patients was divided according to the INR: NRI = (1.519 × serum albumin, g/L) + (41.7 × present weight, kg / usual weight, kg)]. RESULTS All patients were operated. An analysis of the operations performed in three institutions demonstrated mortality in chronic pancreatitis and pancreatic pseudocysts in 1.4%, in chronic pancreatitis and the presence of an inflammatory mass mainly in the pancreatic head in 1.2%, and in cancer of the pancreatic head in 5.9%. The mean preoperative NLR was normal in 33.8% of the patients, the mild physiologic stress level was 54.7%, and the moderate was 11.5% before surgery. 10.2% of patients had a normal nutritional status, 20% had mild, 19.6% had moderate, and 50.2% had severe malnutrition. In a univariate analysis, at the cutoff of NLR ≥ 9.5 (AUC = 0.803) and the cutoff of NRI ≤ 98.5 (AUC = 0.801), increasing the risk of complications was observed (hazard ratio, 2.01; 95% CI, 1.247-3.250, p = 0.006), but at the cutoff of NRI ≤ 83.55 (AUC = 0.81), we observed a survival difference in operated patients (hazard ratio, 2.15; 95% CI, 1.334-3.477, p = 0.0025). CONCLUSIONS Our study demonstrated that NLR and NRI were predictors of postoperative complications, but only NRI was a predictor of 90-day mortality in patients after surgery.
Collapse
Affiliation(s)
- Igor A Kryvoruchko
- Department of Surgery No.2, Kharkiv National Medical University, Nezalezhnosti Avenue, Kharkiv, 61022, Ukraine.
| | - Plamen Staikov
- Department of Surgery No.2, Kharkiv National Medical University, Nezalezhnosti Avenue, Kharkiv, 61022, Ukraine
- Krankenhaus Sachsenhausen, 60594, SchulstraßeFrankfurt Am Main, Germany
| | - Valeriy V Boyko
- Institute General and Emergency Surgery Named After V.T. Zaitcev of the National Academy of Medical Sciences of Ukraine, Balakireva Entry, Kharkiv, 61103, Ukraine
- Department of Surgery No.1, Kharkiv National Medical University, Balakireva Entry, Kharkiv, 61103, Ukraine
| | - Massimo Sartelli
- Department of Surgery Macerata Hospital, Santa Lucia Street, 62100, Macerata, Italy
- Institute of Bio-Stem Cell Rehabilitation, Ukraine Association of Biobank, Puskinska Str, Kharkiv, 61022, Ukraine
| | - Yulia V Ivanova
- Department of Surgery No.1, Kharkiv National Medical University, Balakireva Entry, Kharkiv, 61103, Ukraine
| | - Andrij Honcharov
- Department of Surgery No.2, Kharkiv National Medical University, Nezalezhnosti Avenue, Kharkiv, 61022, Ukraine
| | - Svetlana Gramatiuk
- Institute of Bio-Stem Cell Rehabilitation, Ukraine Association of Biobank, Puskinska Str, Kharkiv, 61022, Ukraine
- International Biobanking and Education, Medical University of Graz, Elisabethstraße, 8010, Graz, Austria
| | - Karine Sargsyan
- International Biobanking and Education, Medical University of Graz, Elisabethstraße, 8010, Graz, Austria
| |
Collapse
|
5
|
Balcioglu O, Kahraman Ü, Ertugay S, Engin C, Yagdi T, Ozbaran M. Association of Nutritional Risk Index With Continuous Flow Left Ventricular Assist Device Complications. Transplant Proc 2023; 55:1278-1282. [PMID: 37268536 DOI: 10.1016/j.transproceed.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/30/2023] [Accepted: 05/12/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Studies revealing the relationship between major surgery outcomes and nutritional parameters are increasing daily. Publications demonstrating the relationship between early postoperative success and surgical complications in patients with chronic heart failure and continuous flow left ventricular assist device (cf-LVAD) are limited. The vast majority of patients with advanced chronic heart failure are cachexic, and the reason for this is multifactorial. The aim of this study is to investigate the link between the modified nutritional risk index (NRI) and 6-month survival and complication rates in patients with a cf-LVAD. METHODS This study included statistical analysis of NRI and postoperative parameters of 456 patients with advanced heart failure who had cf-LVAD implantation between 2010 and 2020. RESULTS The results of this study showed a statistically significant difference between mean NRI values and postoperative parameters such as 6-month survival (P = .001), right ventricular failure (P = .003), infection (P = .001), driveline infection (P = .000), and sepsis (P = .000). CONCLUSIONS This study revealed that 6-month postoperative complications and mortality rates of patients with advanced heart failure in patients with cf-LVAD are closely related to malnutrition status. In these patients, nutrition specialist use would be beneficial both preoperatively and postoperatively to increase surveillance and reduce postoperative complications.
Collapse
Affiliation(s)
- Ozlem Balcioglu
- Department of Cardiovascular Surgery, Near East University Faculty of Medicine, Nicosia, Turkish Republic Northern Cyprus.
| | - Ümit Kahraman
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serkan Ertugay
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Cagatay Engin
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Tahir Yagdi
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Ozbaran
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
6
|
Grzywacz A, Lubas A, Niemczyk S. Inferior Nutritional Status Significantly Differentiates Dialysis Patients with Type 1 and Type 2 Diabetes. Nutrients 2023; 15:nu15071549. [PMID: 37049397 PMCID: PMC10096989 DOI: 10.3390/nu15071549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Diabetes mellitus is currently the leading cause of end-stage renal disease. Assessing nutritional status is an important component of care in this group. This prospective observational study aimed to assess the nutritional status of type 1 and type 2 diabetes patients on hemodialysis or peritoneal dialysis and its relationship with hospitalizations and all-cause death. Adult patients with end-stage renal disease, treated with dialysis, and suffering from type 1 or type 2 diabetes, being treated with insulin, were included in the study. Exclusion criteria comprised other types of diabetes, the patient's refusal to participate in the study, and severe disorders impacting verbal-logical communication. The nutritional status based on the Nutritional Risk Index, the Geriatric Nutritional Risk Index, fat distribution measures, and the Charlson Comorbidity Index was estimated for 95 Caucasian dialysis patients with type 1 (n = 25) or type 2 (n = 70) diabetes. Patients with type 1 diabetes exhibited significantly inferior nutritional status and increased nutritional risk than those with type 2 diabetes. Lower values of nutritional indices significantly differentiated patients with type 1 from those with type 2 diabetes, with ≥84% sensitivity and specificity. Inferior nutritional status was related to all-cause hospitalizations, whereas higher comorbidity was associated with a greater likelihood of cardiovascular hospitalizations and all-cause death. The significant difference between patients with type 1 and type 2 diabetes being treated with dialysis indicates that these patients should not be considered as a homogeneous group, while also considering the greater age of patients with type 2 diabetes.
Collapse
Affiliation(s)
- Anna Grzywacz
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Arkadiusz Lubas
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Stanisław Niemczyk
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| |
Collapse
|
7
|
Nemutlu Y, Kaya Cebioğlu I. Consistency of MIS with other malnutrition screening tools among adult and elderly hemodialysis patients. J Healthc Qual Res 2023; 38:68-75. [PMID: 36266184 DOI: 10.1016/j.jhqr.2022.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/18/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM Malnutrition and inflammation commonly occur concomitantly among hemodialysis patients. Malnutrition inflammation score (MIS) is a tool that helps clinical and nutritional evaluation of patients regardless of age. This study aimed to determine the best approach by comparing different tools/indices to evaluate the malnutrition and inflammation status of patients having hemodialysis treatment regarding their age and to examine the clinical benefits and consistency of MIS with other malnutrition tools. METHODS The study was conducted with a sample of 140 hemodialysis patients (70 adults and 70 elderly patients). The biochemical data of the patients were retrospectively obtained, and the research dietitian conducted the anthropometric measures. In addition to MIS, 7 point-SGA (7p-SGA), Nutrition Risk Index (NRI) for adults, and Mini Nutritional Assessment (MNA), Geriatric Nutritional Risk Index (GNRI) for elderly patients were used. The model's discriminatory power was examined by receiver operating characteristics curve analysis. RESULTS Patients who were "at-risk" according to MIS had significantly lower scores of 7p-SGA and NRI than those who had "no risk" (p<0.001). Moreover, those who are "at-risk" have significantly lower MNA scores than those who are not (p=0.002). Among adult patients, MIS displayed lower sensitivity but higher specificity with NRI than 7p-SGA. However, for elderly patients, MIS showed fair sensitivity and specificity with MNA but the highest sensitivity with GNRI. CONCLUSION Although different screening tools are available to screen malnutrition among dialysis patients regarding their age, MIS might be more clincally useful as it is more susceptible to assess both malnutrition and inflammation that occur concomitantly.
Collapse
Affiliation(s)
- Y Nemutlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, İstanbul, Turkey
| | - I Kaya Cebioğlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, İstanbul, Turkey.
| |
Collapse
|
8
|
Dos Santos RCB, do Nascimento SB, de Sousa Rego Mendes T, Santos LS, de Lemos MCC, Pinho CPS. Wasting syndrome and associated factors in hospitalized older people. Exp Gerontol 2022; 170:111985. [PMID: 36280091 DOI: 10.1016/j.exger.2022.111985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/17/2022] [Accepted: 10/18/2022] [Indexed: 12/29/2022]
Abstract
Wasting syndrome (WS) is characterized by clinically important unintentional weight loss >5 % in six to 12 months. This syndrome is responsible for a significant portion of hospitalizations throughout the world and is an important indicator of serious diseases, especially in individuals with 60 years of age or older. The aim of the present study was to investigate WS and associated factors in hospitalized older people. An observational cross-sectional study was developed at a university hospital in Brazil with male and female patients ≥60 years of age. WS was considered in the occurrence of unintentional weight loss of 10 % in 12 months, 7.5 % in six months or >5 % in three months. Data were collected on sociodemographic, clinical, lifestyle, nutritional and biochemical characteristics. This study received approval from the local institutional review board and all participants signed a statement of informed consent. The sample was composed of 178 older people with a mean age of 70.0 ± 8.0 years. The prevalence of WS was 45.5 %. WS was associated with the following clinical variables: conservative CKD (p = 0.007), dysphagia (p = 0.035), dementia (p = 0.017), anorexia (p < 0.001), fatigue (p = 0.001), functional dependence (measured using the Barthel Index) (p = 0.001) and medications that cause malabsorption (p = 0.020); the following nutritional variables: body mass index (p < 0.001), low calf circumference (p < 0.001), low muscle strength (p = 0.001), low muscle mass (p < 0.001) and undernourishment or risk of malnutrition (evaluated using the Mini Nutritional Assessment); and the following biochemical variables: high CRP (p = 0.027), hypoalbuminemia (p = 0.005) and anemia (p < 0.001). The prevalence of WS was high among the hospitalized older people in the present sample and was associated with clinical and biochemical aspects as well as all nutritional variables analyzed. In contrast, lifestyle and sociodemographic characteristics were not associated with wasting syndrome.
Collapse
Affiliation(s)
| | | | | | - Letícia Sabino Santos
- Hospital das Clínicas - UFPE, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil
| | | | - Cláudia Porto Sabino Pinho
- Hospital das Clínicas, UFPE. Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil
| |
Collapse
|
9
|
Mazurek M, Mlak R, Homa-Mlak I, Powrózek T, Brzozowska A, Kwaśniewski W, Opielak G, Małecka-Massalska T. High miR-511-3p Expression as a Potential Predictor of a Poor Nutritional Status in Head and Neck Cancer Patients Subjected to Intensity-Modulated Radiation Therapy. J Clin Med 2022; 11:jcm11030805. [PMID: 35160257 PMCID: PMC8836435 DOI: 10.3390/jcm11030805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Nutritional deficiencies, including malnutrition and its irreversible type cachexia, are often observed in patients with head and neck cancer (HNC). Among the various factors contributing to the occurrence of these disorders, inflammation seems to be crucial. The potential regulatory properties of miR-511-3p, e.g., post-translational alteration of expression of genes with protein products that are involved in inflammation, may be related to nutritional deficiencies observed in HNC patients. Therefore, the aim of our study was to assess the correlation between pretreatment miR-511-3p expression and nutritional status in patients undergoing radiotherapy (RT) due to HNC. In our retrospective study, 60 consecutively admitted patients treated with intensity-modulated radiotherapy (IMRT) due to advanced HNC were enrolled. The analysis of miR-511-3p expression was performed using real-time PCR. Significantly higher expression of miR-511-3p was observed in well-nourished patients compared to patients with moderate or severe malnutrition (p = 0.0001). Pretreatment expression of miR-511-3p may be a useful biomarker of nutritional deficiencies in patients subjected to IMRT due to HNC.
Collapse
Affiliation(s)
- Marcin Mazurek
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
- Correspondence: ; Tel.: +48-81448-60-80
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
| | - Tomasz Powrózek
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
| | - Anna Brzozowska
- II Department of Radiotherapy, Center of Oncology of the Lublin Region St. John of Dukla, 20-090 Lublin, Poland;
| | - Wojciech Kwaśniewski
- Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Grzegorz Opielak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
| | - Teresa Małecka-Massalska
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (I.H.-M.); (T.P.); (G.O.); (T.M.-M.)
| |
Collapse
|
10
|
Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: An evidence based systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
11
|
Ha JW, Pyo JY, Ahn SS, Song JJ, Park YB, Lee SW. Nutrition Risk Index Score at Diagnosis Can Effectively Predict Poor Prognosis in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. J Ren Nutr 2021; 32:423-431. [PMID: 34294554 DOI: 10.1053/j.jrn.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/08/2021] [Accepted: 06/06/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study investigated whether the nutritional risk index (NRI) score at diagnosis might be useful for anticipating poor prognosis, in particular, all-cause mortality and end-stage renal disease (ESRD) in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS The medical records of 242 immunosuppressive drug-naïve patients with AAV were retrospectively reviewed. Data at diagnosis and poor prognosis and medications during follow-up were assessed. The NRI score was calculated by 1.519 × serum albumin (g/L) + 41.7 × present (kg)/ideal body weight (kg). RESULTS The median age at diagnosis of patients with AAV (131 microscopic polyangiitis, 62 granulomatosis with polyangiitis, and 49 eosinophilic granulomatosis with polyangiitis) was 60 years (85 male). During follow-up, twenty-nine patients (12.0%) died after a period of 35.9 months, and 42 patients (17.4%) had ESRD for a period of 30.0 months. Using the receiver operator characteristic curve, the cutoffs of the NRI scores for all-cause mortality and ESRD were calculated as NRI ≤ 101.95 (sensitivity, 46.5%; specificity, 89.7%) and NRI ≤ 99.85 (sensitivity, 57.0%; specificity, 83.3%). In the multivariable Cox hazard model analyses, age (hazard ratio [HR], 1.035), five-factor score (HR, 1.623), and the NRI score ≤ 101.95 (HR, 4.262) were independent predictors of all-cause mortality, whereas, five-factor score (HR, 1.516), hypertension (HR, 1.906), and the NRI score ≤ 99.85 (HR, 3.623) were independent predictors of ESRD occurrence during follow-up in patients with AAV. CONCLUSIONS The NRI score at diagnosis may be a useful index to anticipate all-cause mortality and ESRD occurrence during follow-up in patients with AAV.
Collapse
Affiliation(s)
- Jang Woo Ha
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Yoon Pyo
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
12
|
Almutawa DA, Almuammar M, Elshafie MM, Aljuraiban GS, Alnafisah A, Abulmeaty MMA. Survival and Nutritional Status of Male and Female Heart Transplant Patients Based on the Nutritional Risk Index. Nutrients 2020; 12:nu12123868. [PMID: 33348880 PMCID: PMC7766250 DOI: 10.3390/nu12123868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 01/30/2023] Open
Abstract
Malnutrition among heart-transplant patients may affect survival. The aim was to investigate the survival and nutrition status among male and female heart transplant patients who underwent transplantation, before and 1 year after surgery based on the nutritional risk index (NRI). The medical records of ninety heart-transplant patients (2009–2014) from the King Faisal Specialist Hospital, Riyadh, were reviewed. The assessment included demographic data, anthropometric measurements, and NRI calculation. Moreover, postoperative data included the length of stay and survival. Paired t-test and survival analysis by Kaplan–Meier (KM) curves were used. A total of 90 patients (males 77.78%) were included. The prevalence of malnutrition in the preoperative phase by NRI was 60% (7.78% as severe; 40% as moderate, and 12.22% mild NRI scores). After 1 year, body mass index (BMI) and NRI increased significantly (p < 0.001). Furthermore, NRI was significantly different between men and women (p < 0.01), while KM survival curves were insignificantly different (p = 0.67). Recipients with postoperative moderate or severe nutritional risk (NRI < 97.5) had significantly shorter survival in the first-year post-transplantation (HR = 0.82; 95% CI, 0.75–0.89; p < 0.001). Our findings indicate that the NRI after 1 year of transplant correlated significantly with mortality. Besides, there was no significant gender difference regarding survival; however, malnutrition and low survival were more prominent among women.
Collapse
Affiliation(s)
- Deema A. Almutawa
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (D.A.A.); (M.A.); (M.M.E.); (G.S.A.)
- Health Sciences Department, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - May Almuammar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (D.A.A.); (M.A.); (M.M.E.); (G.S.A.)
| | - Mona Mohamed Elshafie
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (D.A.A.); (M.A.); (M.M.E.); (G.S.A.)
- Al Ghad International College of Applied Medical Sciences, Riyadh 12467, Saudi Arabia
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (D.A.A.); (M.A.); (M.M.E.); (G.S.A.)
| | - Alaa Alnafisah
- Clinical Nutrition Department, King Faisal Specialist Hospital and Research Center, Riyadh 12713, Saudi Arabia;
| | - Mahmoud M. A. Abulmeaty
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (D.A.A.); (M.A.); (M.M.E.); (G.S.A.)
- Obesity Management and Research Unit, Medical Physiology Department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
- Correspondence: ; Tel.: +966-5-4815-5983
| |
Collapse
|
13
|
Berger M, Yamada A, Komaki Y, Komaki F, Cohen RD, Dalal S, Hurst RD, Hyman N, Pekow J, Shogan BD, Umanskiy K, Rubin DT, Sakuraba A, Micic D. Low Skeletal Muscle Index Adjusted for Body Mass Index Is an Independent Risk Factor for Inflammatory Bowel Disease Surgical Complications. CROHN'S & COLITIS 360 2020; 2:otaa064. [PMID: 36776498 PMCID: PMC9802466 DOI: 10.1093/crocol/otaa064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study aims to evaluate sarcopenia defined by skeletal muscle index (SMI) with cutoffs adjusted for sex and body mass index as a predictive marker for postoperative outcomes among individuals with inflammatory bowel disease. Methods The SMI was measured using the cross-sectional computed tomography images at the lumbar spine. Multivariate logistic regression was performed to identify independent risk factors of postoperative complications. Results Ninety-one patients were included in the study. In multivariate analysis, sarcopenia (odds ratio = 5.37; confidence interval: 1.04-27.6) was predictive of infectious postoperative complications. Conclusions Sarcopenia as defined by the SMI is a predictor for 30-day postoperative infection complications in inflammatory bowel disease surgeries.
Collapse
Affiliation(s)
- Matthew Berger
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Akihiro Yamada
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA,Section of Gastroenterology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Yuga Komaki
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Fukiko Komaki
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Russell D Cohen
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Sushila Dalal
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Roger D Hurst
- Section of Colon and Rectal Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Neil Hyman
- Section of Colon and Rectal Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Joel Pekow
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Benjamin D Shogan
- Section of Colon and Rectal Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Konstantin Umanskiy
- Section of Colon and Rectal Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - David T Rubin
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Atsushi Sakuraba
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Dejan Micic
- Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, USA,Address correspondence to: Dejan Micic, MD, 5841 South Maryland Avenue, MC4076, Chicago, IL 60637 ()
| |
Collapse
|
14
|
Effects of an Omaha system-based continuing nursing program on nutritional status in patients undergoing peritoneal dialysis: a randomized controlled trial. Int Urol Nephrol 2020; 52:981-989. [DOI: 10.1007/s11255-020-02449-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/16/2020] [Indexed: 12/24/2022]
|
15
|
Kang MK, Kim TJ, Kim Y, Nam KW, Jeong HY, Kim SK, Lee JS, Ko SB, Yoon BW. Geriatric nutritional risk index predicts poor outcomes in patients with acute ischemic stroke - Automated undernutrition screen tool. PLoS One 2020; 15:e0228738. [PMID: 32053672 PMCID: PMC7017988 DOI: 10.1371/journal.pone.0228738] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/21/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Premorbid undernutrition has been proven to have an adverse effect on the prognosis of stroke patients. The evaluation of nutritional status is important, but there is no universally accepted screen methodology. PURPOSE We aimed to use the geriatric nutritional risk index (GNRI) for evaluating the effect of premorbid undernutrition on short-term outcomes in patients with acute ischemic stroke. METHODS A total of 1,906 patients were included for analysis. Baseline characteristics were collected. We evaluated the nutritional status of the patients using the GNRI and body mass index(BMI). The GNRI was calculated as {1.519×serum albumin(g/dL) + 41.7×present weight (kg)/ideal body weight (kg)}. All patients were categorized into four groups on the basis of the GNRI score. RESULTS Among the included patients, 546 patients had an unfavorable outcomes. The proportion of patients with moderate and severe risk, assessed in GNRI, was significantly higher in the unfavorable outcome group compared to the favorable outcome group (33.3% vs 15.0%). The increased risk of premorbid undernutrition was associated with an increased risk of unfavorable outcome in a dose-response manner after adjusting for covariates. CONCLUSIONS This study demonstrated that GNRI was associated with poor prognosis in patients with acute ischemic stroke. GNRI may be used to screen patients at high risk for unfavorable outcome.
Collapse
Affiliation(s)
- Min Kyoung Kang
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Jung Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Ki-Woong Nam
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Kyung Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea
| | - Sang-Bae Ko
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung-Woo Yoon
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
16
|
Ehresman J, Ahmed AK, Schilling A, Pennington Z, Lubelski D, Cottrill E, Goodwin ML, Liddy A, Abu-Bonsrah N, Goodwin CR, Sciubba DM. Preoperative Nutrition Consults Associated with Decreased Postoperative Complication Rate and Decreased Length of Hospital Stay After Spine Metastasis Surgery. World Neurosurg 2020; 133:e173-e179. [DOI: 10.1016/j.wneu.2019.08.197] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/11/2022]
|
17
|
Knappe-Drzikova B, Maasberg S, Vonderbeck D, Krafft TA, Knüppel S, Sturm A, Müller-Nordhorn J, Wiedenmann B, Pape UF. Malnutrition predicts long-term survival in hospitalized patients with gastroenterological and hepatological diseases. Clin Nutr ESPEN 2019; 30:26-34. [PMID: 30904226 DOI: 10.1016/j.clnesp.2019.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND & AIMS Malnutrition is a common problem in hospitalized patients, influencing treatment outcomes, length of hospital stay, quality of life and overall survival. However, the association of nutritional status parameters with long-term mortality has not yet been studied systematically in gastroenterological-hepatological patients. The present study aimed to assess the association between nutritional status parameters as characterized by Nutritional Risk Screening (NRS), anthropometry, serum transferrin, bioelectrical impedance analysis (BIA) and long-term overall survival in hospitalized gastroenterological-hepatological patients. METHODS Nutritional status was assessed in 644 gastroenterological-hepatological patients by NRS score. In addition, body mass index (BMI) and serum transferrin were determined and BIA was performed. Mid-upper arm circumference (MUAC) and triceps skinfold thickness (TST) were measured. Patients were followed for a mean period of 67 months (mean 54.8, range 0-107 months). RESULTS During malnutrition screening, 475 (73.8%) patients were diagnosed as sufficiently nourished by NRS (NRS 0-2), while an increased risk of malnutrition was found in 169 (26.2%) patients (NRS≤3). Malnutrition was significantly associated with less favourable results for BMI (p < 0.001), serum transferrin (p < 0.001), BIA (p < 0.001), MUAC (p < 0.001) and TST (p < 0.05). Overall 5-year survival rates (YSR) were much shorter in malnourished patients whether with (5-YSR: 43.9%) or without (73.6%) malignancy. Overall 5-year survival rates (YSR) were much shorter in malnourished patients whether with (5-YSR: 43.9%) or without (73.6%) malignancy. By the multivariable analysis the NRS ≥3 and, phase angle (PhA) over the 5th percentile or over the mean of the cohort were found to be associated with long-term survival. CONCLUSIONS Malnutrition is highly prevalent in hospitalized gastroenterological-hepatological patients and is associated with distinct clinical diagnoses. In the present study we demonstrated that malnutrition characterized by the NRS, anthropometry, serum transferrin and BIA, not only predicts short-term but also significantly poor long-term outcome in these patients.
Collapse
Affiliation(s)
- Barbora Knappe-Drzikova
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany.
| | - Sebastian Maasberg
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany
| | - Dorothée Vonderbeck
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany
| | - Thomas A Krafft
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany
| | - Sven Knüppel
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Andreas Sturm
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany; Department of Gastroenterology, DRK-Kliniken Westend, Berlin, Germany
| | | | - Bertram Wiedenmann
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany
| | - Ulrich-Frank Pape
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine, Berlin, Germany; Department of Internal Medicine and Gastroenterology, Asklepios Klinik St. Georg, Hamburg, Germany
| |
Collapse
|
18
|
Liu S, Zhuang X, Zhang M, Wu Y, Liu M, Guan S, Liu S, Miao L, Cui W. Application of automated peritoneal dialysis in urgent-start peritoneal dialysis patients during the break-in period. Int Urol Nephrol 2018; 50:541-549. [PMID: 29340842 PMCID: PMC5845069 DOI: 10.1007/s11255-018-1785-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 01/02/2018] [Indexed: 12/13/2022]
Abstract
Objective Whether automated peritoneal dialysis (APD) is a feasible strategy for urgent-start peritoneal dialysis (PD) therapy during the break-in period remains unclear. This study was conducted to compare the efficacy as well as complications among three PD modes during the break-in period. Methods Ninety-six patients treated with urgent-start PD after catheterization were retrospectively analyzed. Patients were divided into three groups, incremental continuous ambulatory PD (CAPD) group (n = 26); APD group (n = 42); and APD–CAPD group (n = 28). Clinical parameters at the end of the break-in period and 1 month after the initiation of PD treatment were collected and analyzed. Results Compared with the traditional incremental CAPD, APD and APD–CAPD were superior as they could effectively remove small-molecule uremic toxins and correct electrolyte imbalance (P < 0.05), while did not increase the incidence of early complications during the break-in period (P > 0.05). However, APD led to a significant decline in albumin and pre-albumin, as compared with APD–CAPD and CAPD (P < 0.05). A PD strategy consisting 6 days of APD and 3 days of CAPD showed a great advantage in preventing excessive protein loss. There were no significant differences in all tested biochemical parameters among the three groups at 1 month after treatment (all P > 0.05). Conclusion Application of APD for urgent-start PD during the break-in period is feasible. A combination of APD and CAPD regimens seems to be a more reasonable mode.
Collapse
Affiliation(s)
- Shengmao Liu
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Xiaohua Zhuang
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Min Zhang
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Yanfeng Wu
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Min Liu
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Sibo Guan
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Shujun Liu
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Lining Miao
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China
| | - Wenpeng Cui
- Department of Nephrology, Second Hospital, Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin, China.
| |
Collapse
|