https://scholars.lib.ntu.edu.tw/handle/123456789/579398
標題: | Changes in anthropometry and mortality in maintenance hemodialysis patients in the HEMO study | 作者: | CHI-TING SU Yabes J. Pike F. Weiner D.E. Beddhu S. Burrowes J.D. Rocco M.V. Unruh M.L. |
關鍵字: | Anthropometry; body mass index (BMI); hemodialysis; joint model analysis; survival analysis | 公開日期: | 2013 | 卷: | 62 | 期: | 6 | 起(迄)頁: | 1141-1150 | 來源出版物: | American Journal of Kidney Diseases | 摘要: | Background: Poor nutritional status has been associated with worse patient survival in maintenance hemodialysis patients. Anthropometric values are important nutritional measures, incorporating muscle and fat mass. However, the association of changes in anthropometry, including midarm circumference (MAC) and skinfold measurements, with mortality in hemodialysis patients remains unknown. Accordingly, we explored this association in the Hemodialysis (HEMO) Study. Study Design: Post hoc analysis of cohort data from a clinical trial. Setting & Participants: 1,846 hemodialysis patients enrolled in the HEMO Study. Predictors: MAC and skinfold measurements. Outcomes: Longitudinal changes in MAC and skinfolds were jointly modeled using repeated measures and survival modeling. Time-to-event outcomes were all-cause mortality, cardiac death and hospitalization, and infection-related death. Results: Mean MAC was 30.1 cm, and mean baseline sum of subscapular, biceps, and triceps skinfolds was 42.4 mm. During a median follow-up of 2.5 years, there were 845 deaths. During follow-up, MAC and the skinfold measurement declined 0.26 cm and 1.1 mm per year, respectively. Declines in MAC (per cm) and skinfold (per mm) measurements were associated with higher all-cause mortality (HRs of 1.58 [95% CI, 1.29-1.94; P < 0.001] and 1.06 [95% CI, 0.99-1.13; P = 0.09], respectively), poorer cardiac outcomes (HRs of 1.49 [95% CI, 1.23-1.81; P < 0.001] and 1.05 [95% CI, 0.99-1.10; P = 0.09], respectively), and higher infection-related hospitalization (HRs of 2.45 [95% CI, 1.55-3.88; P < 0.001] and 1.16 [95% CI, 0.98-1.37; P = 0.08], respectively). The association between declining MAC and skinfold with patient survival was most notable for those with body mass index (BMI) ?25 kg/m2 (HRs of 2.41 [95% CI, 1.81-3.19; P < 0.001] and 1.22 [95% CI, 1.10-1.35; P < 0.001], respectively). Limitations: Prevalent dialysis patients only, excluding individuals weighing >85 kg. Conclusions: Declines in skinfold thickness were not associated significantly with outcomes except for participants with BMI ?25 kg/m2. Declines in MAC are associated significantly with all-cause mortality and cardiac outcomes in hemodialysis patients, most notably in those with BMI ?25 kg/m2. ? 2013 National Kidney Foundation, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84888312101&doi=10.1053%2fj.ajkd.2013.05.015&partnerID=40&md5=54984144aeb5022d4a7f50bb748265bd https://scholars.lib.ntu.edu.tw/handle/123456789/579398 |
ISSN: | 0272-6386 | DOI: | 10.1053/j.ajkd.2013.05.015 | SDG/關鍵字: | adult; anthropometric parameters; anthropometry; article; biceps brachii muscle; body mass; cohort analysis; female; follow up; heart death; hemodialysis patient; hospitalization; human; infection; maintenance therapy; major clinical study; male; midarm circumference; mortality; outcome assessment; skinfold; skinfold thickness; subscapularis muscle; aged; cause of death; clinical trial; comparative study; controlled study; Kidney Failure, Chronic; longitudinal study; middle aged; multicenter study; nutritional status; procedures; randomized controlled trial; renal replacement therapy; statistics and numerical data; survival; United States; Adult; Aged; Anthropometry; Body Mass Index; Cause of Death; Female; Hospitalization; Humans; Kidney Failure, Chronic; Longitudinal Studies; Male; Middle Aged; Nutritional Status; Renal Dialysis; Skinfold Thickness; Survival Analysis; United States |
顯示於: | 醫學系 |
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