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Abstract: TH-PO601

Clinical Significance of Nutritional Predictors in Prevalent Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Bae, Eunjin, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Cho, Junhyeong, Change-won Gyungsang National University, Chang-won, Korea (the Republic of)
  • Na, Jeonggu, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
  • Lee, Tae won, Gyeongsang National University Hospital, Changwon-si, Gyeongsangnam-do, Korea (the Republic of)
  • Jang, Ha nee, Gyeongsang National Univ. Hospital, Jinju, Korea (the Republic of)
  • Chang, Se-Ho, Gyeongsang National University Hospital, Changwon-si, Gyeongsangnam-do, Korea (the Republic of)
  • Park, Dong Jun, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)
Background

Nutrition has been consistently important in end stage renal disease patients. However, it is difficult to obtain adequate nutritional status while avoiding fluid overload, hyperphosphatemia and hyperkalemia in hemodialysis patients. We studied the clinical significance of serum albumin and other nutritional markers in maintenance hemodialysis patients.

Methods

We retrospectively enrolled patients who received hemodialysis for more than 3 months from 2016 to March 2019, excluding patients who died within 30 days. We evaluated the factors associated with all-cause mortality and major adverse cardiovascular events (MACE). In addition, we investigated factors related with sarcopenia defined as skeletal muscle mass index (SMI) ≤10.75 kg/m2 (men) or ≤6.75 kg/m2 (women) by using a BIA machine (InBody S10; Biospace, Korea).

Results

Of 284 patients, 63.7% were men, mean age was 64.2 ± 12.4 years, mean body mass index (BMI) was 23.7 ± 6.9 kg/m2, and the most common underlying disease were hypertension and diabetes. During a median follow up of 16.7 months, 13.7% (n=39) patients experienced a MACE, 12.3% (N=35) patients died. In multivariate Cox analyses, lower albumin, higher CRP level and history of CVD were significantly related with all-cause mortality even after adjustment for covariates. SMI had a significant positive correlation with BMI, serum phosphorus, BUN, creatinine and uric acid level. SMI was not predicted all-cause mortality in total group, but was significantly predicted all-cause mortality in diabetes subgroup. In the logistic regression analyses, older, lower BMI, diabetes and male sex were significantly associated with sarcopenia. In addition, higher serum calcium, phosphorus level, history of CVD, cerebrovascular accident (CVA) were significantly associated with MACE.

Conclusion

In prevalent hemodialysis patients, nutrition, inflammation and precious CVD are the major risk factors for all-cause mortality. SMI might be an important predictor for all-cause mortality in diabetic patients. In patients with history of CVD or CVA, management of serum calcium and phosphorus is particularly important in aspect of MACE.