Kou Kitabayashi1,2, Suguru Yamamoto3, Ichiei Narita1. 1. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata-si, Niigata, 951-8510, Japan. 2. Shinkohkai Murakami Kinen Hospital, 204-1 Matuyama, Murakami-si, Niigata, 958-0034, Japan. 3. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata-si, Niigata, 951-8510, Japan. yamamotos@med.niigata-u.ac.jp.
Abstract
AIM: The nutritional risk index for Japanese hemodialysis (NRI-JH) is a nutritional screening tool for predicting mortality in patients undergoing hemodialysis; however, its utility in patients undergoing hemodialysis during long-term hospitalization who have a high risk of protein-energy wasting, is unclear. METHODS: This retrospective study assessed hospitalized patients undergoing hemodialysis during long-term care at a single hospital. The NRI-JH was calculated using body mass index, serum albumin level, total cholesterol level, and serum creatinine level. The patients were categorized into three risk groups-low, medium, and high. Dietary energy and protein intake were evaluated by dietitians. The association of NRI-JH risk with nutritional intake and mortality were examined. RESULTS: In total, 133 patients were analyzed. The NRI-JH risk was low in 24%, medium in 26%, and high in 50% of the patients. The patients in the high-risk group were older and had lower energy and protein intakes than those in the low- and medium-risk groups. High-risk patients showed shorter survival times than low- and medium-risk patients, and a high NRI-JH risk was associated with a high mortality rate (hazard ratio [HR], 2.12; 95% confidence interval [CI], 1.08-4.77; p < 0.05). The association weakened when protein intake and C-reactive protein level were added as covariates (HR, 2.01; 95% CI, 0.95-4.28, p = 0.07). CONCLUSIONS: High NRI-JH risk was associated with low dietary nutritional intake and poor survival in patients undergoing hemodialysis during long-term hospitalization. Nutritional status evaluation and nutritional interventions may improve prognosis in this population.
AIM: The nutritional risk index for Japanese hemodialysis (NRI-JH) is a nutritional screening tool for predicting mortality in patients undergoing hemodialysis; however, its utility in patients undergoing hemodialysis during long-term hospitalization who have a high risk of protein-energy wasting, is unclear. METHODS: This retrospective study assessed hospitalized patients undergoing hemodialysis during long-term care at a single hospital. The NRI-JH was calculated using body mass index, serum albumin level, total cholesterol level, and serum creatinine level. The patients were categorized into three risk groups-low, medium, and high. Dietary energy and protein intake were evaluated by dietitians. The association of NRI-JH risk with nutritional intake and mortality were examined. RESULTS: In total, 133 patients were analyzed. The NRI-JH risk was low in 24%, medium in 26%, and high in 50% of the patients. The patients in the high-risk group were older and had lower energy and protein intakes than those in the low- and medium-risk groups. High-risk patients showed shorter survival times than low- and medium-risk patients, and a high NRI-JH risk was associated with a high mortality rate (hazard ratio [HR], 2.12; 95% confidence interval [CI], 1.08-4.77; p < 0.05). The association weakened when protein intake and C-reactive protein level were added as covariates (HR, 2.01; 95% CI, 0.95-4.28, p = 0.07). CONCLUSIONS: High NRI-JH risk was associated with low dietary nutritional intake and poor survival in patients undergoing hemodialysis during long-term hospitalization. Nutritional status evaluation and nutritional interventions may improve prognosis in this population.
Authors: Hye-Eun Byeon; Ja Young Jeon; Hae Jin Kim; Dae Jung Kim; Kwan-Woo Lee; Yup Kang; Seung Jin Han Journal: Nutrients Date: 2017-12-18 Impact factor: 5.717
Authors: Lina Johansson; Denis Fouque; Vincenzo Bellizzi; Philippe Chauveau; Anne Kolko; Pablo Molina; Siren Sezer; Pieter M Ter Wee; Daniel Teta; Juan J Carrero Journal: Nephrol Dial Transplant Date: 2017-07-01 Impact factor: 5.992