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Titolo:
Influence of nutritional factors and hemodialysis adequacy on the survivalof 1,610 French patients
Autore:
Combe, C; Chauveau, P; Laville, M; Fouque, D; Azar, R; Cano, N; Canaud, B; Roth, H; Leverve, X; Aparicio, M;
Indirizzi:
Hop Pellegrin, Serv Nephrol, F-33076 Bordeaux, France Hop Pellegrin Bordeaux France F-33076 Nephrol, F-33076 Bordeaux, France Hop Edouard Herriot, Serv Nephrol, Lyon, France Hop Edouard Herriot LyonFrance ard Herriot, Serv Nephrol, Lyon, France Ctr Hosp Gen, Serv Med Interne B, Dunkerque, France Ctr Hosp Gen Dunkerque France en, Serv Med Interne B, Dunkerque, France Clin Residence Parc, Marseille, France Clin Residence Parc Marseille France Residence Parc, Marseille, France Hop Lapeyronie, Serv Nephrol, Montpellier, France Hop Lapeyronie Montpellier France ie, Serv Nephrol, Montpellier, France Univ Grenoble 1, Lab Bioenerget Fondamentale & Appl, Grenoble, France UnivGrenoble 1 Grenoble France t Fondamentale & Appl, Grenoble, France
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 1, volume: 37, anno: 2001, supplemento:, 2
pagine: S81 - S88
SICI:
0272-6386(200101)37:1<S81:IONFAH>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENAL REPLACEMENT THERAPY; UREA REDUCTION RATIO; DEATH RISK; MORTALITY; KT/V; HYPOALBUMINEMIA; DIALYSIS; MALNUTRITION; VARIABLES; DISEASE;
Keywords:
albumin; hemodialysis; lean body mass; nutrition; prealbumin; survival;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Combe, C Hop Pellegrin, Serv Nephrol, F-33076 Bordeaux, France Hop Pellegrin Bordeaux France F-33076 F-33076 Bordeaux, France
Citazione:
C. Combe et al., "Influence of nutritional factors and hemodialysis adequacy on the survivalof 1,610 French patients", AM J KIDNEY, 37(1), 2001, pp. S81-S88

Abstract

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. Dataincluding 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 patientswere 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 befocused on the most efficient ways to maintain nutritional status in thesepatients. (C) 2001 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 12:05:45