Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients: A prospective cohort study

Tuyen Van Duong, Pei Yu Wu, Te Chih Wong, Hsi Hsien Chen, Tso Hsiao Chen, Yung Ho Hsu, Sheng Jeng Peng, Ko Lin Kuo, Hsiang Chung Liu, En Tzu Lin, Yi Wei Feng, Shwu Huey Yang

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients' characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan-Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.During the median of follow-up time of 1.4 (1.0-3.2) years, 47 (12.5%) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95% confidence interval, 95%CI, 0.82-0.99; P = .036), body fat mass (HR, 0.95; 95%CI, 0.91-1.00; P = .031), percent body fat (HR, 0.96; 95%CI, 0.92-0.99; P = .024), serum creatinine (HR, 0.81; 95%CI, 0.68-0.96; P = .015), and eKt/V (HR, 0.07; 95%CI, 0.01-0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95%CI, 1.59-5.27; P < .001), hyperglycemia (HR, 2.16; 95%CI, 1.06-4.40; P = .033), and low serum uric acid (HR, 2.22; 95%CI, 1.15-4.31; P = .018) increased the death risk.In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.

原文英語
頁(從 - 到)e14930
期刊Medicine
98
發行號12
DOIs
出版狀態已發佈 - 三月 1 2019

指紋

Renal Dialysis
Blood Glucose
Adipose Tissue
Dialysis
Cohort Studies
Biomarkers
Prospective Studies
Mortality
Body Composition
Uric Acid
Hyperglycemia
Creatinine
Serum
Inflammation
Electric Impedance
Proportional Hazards Models
Multivariate Analysis
Confidence Intervals
Morbidity

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients : A prospective cohort study. / Duong, Tuyen Van; Wu, Pei Yu; Wong, Te Chih; Chen, Hsi Hsien; Chen, Tso Hsiao; Hsu, Yung Ho; Peng, Sheng Jeng; Kuo, Ko Lin; Liu, Hsiang Chung; Lin, En Tzu; Feng, Yi Wei; Yang, Shwu Huey.

於: Medicine, 卷 98, 編號 12, 01.03.2019, p. e14930.

研究成果: 雜誌貢獻文章

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title = "Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients: A prospective cohort study",
abstract = "Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients' characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan-Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.During the median of follow-up time of 1.4 (1.0-3.2) years, 47 (12.5{\%}) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95{\%} confidence interval, 95{\%}CI, 0.82-0.99; P = .036), body fat mass (HR, 0.95; 95{\%}CI, 0.91-1.00; P = .031), percent body fat (HR, 0.96; 95{\%}CI, 0.92-0.99; P = .024), serum creatinine (HR, 0.81; 95{\%}CI, 0.68-0.96; P = .015), and eKt/V (HR, 0.07; 95{\%}CI, 0.01-0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95{\%}CI, 1.59-5.27; P < .001), hyperglycemia (HR, 2.16; 95{\%}CI, 1.06-4.40; P = .033), and low serum uric acid (HR, 2.22; 95{\%}CI, 1.15-4.31; P = .018) increased the death risk.In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.",
author = "Duong, {Tuyen Van} and Wu, {Pei Yu} and Wong, {Te Chih} and Chen, {Hsi Hsien} and Chen, {Tso Hsiao} and Hsu, {Yung Ho} and Peng, {Sheng Jeng} and Kuo, {Ko Lin} and Liu, {Hsiang Chung} and Lin, {En Tzu} and Feng, {Yi Wei} and Yang, {Shwu Huey}",
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T1 - Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients

T2 - A prospective cohort study

AU - Duong, Tuyen Van

AU - Wu, Pei Yu

AU - Wong, Te Chih

AU - Chen, Hsi Hsien

AU - Chen, Tso Hsiao

AU - Hsu, Yung Ho

AU - Peng, Sheng Jeng

AU - Kuo, Ko Lin

AU - Liu, Hsiang Chung

AU - Lin, En Tzu

AU - Feng, Yi Wei

AU - Yang, Shwu Huey

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients' characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan-Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.During the median of follow-up time of 1.4 (1.0-3.2) years, 47 (12.5%) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95% confidence interval, 95%CI, 0.82-0.99; P = .036), body fat mass (HR, 0.95; 95%CI, 0.91-1.00; P = .031), percent body fat (HR, 0.96; 95%CI, 0.92-0.99; P = .024), serum creatinine (HR, 0.81; 95%CI, 0.68-0.96; P = .015), and eKt/V (HR, 0.07; 95%CI, 0.01-0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95%CI, 1.59-5.27; P < .001), hyperglycemia (HR, 2.16; 95%CI, 1.06-4.40; P = .033), and low serum uric acid (HR, 2.22; 95%CI, 1.15-4.31; P = .018) increased the death risk.In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.

AB - Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients' characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan-Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.During the median of follow-up time of 1.4 (1.0-3.2) years, 47 (12.5%) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95% confidence interval, 95%CI, 0.82-0.99; P = .036), body fat mass (HR, 0.95; 95%CI, 0.91-1.00; P = .031), percent body fat (HR, 0.96; 95%CI, 0.92-0.99; P = .024), serum creatinine (HR, 0.81; 95%CI, 0.68-0.96; P = .015), and eKt/V (HR, 0.07; 95%CI, 0.01-0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95%CI, 1.59-5.27; P < .001), hyperglycemia (HR, 2.16; 95%CI, 1.06-4.40; P = .033), and low serum uric acid (HR, 2.22; 95%CI, 1.15-4.31; P = .018) increased the death risk.In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.

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