Abstract: FR-PO916
Extracellular Volume Expansion and Inflammation Are Independently Associated with Malnutrition, Determined by Geriatric Nutritional Risk Index in Hemodialysis Patients
Session Information
- Geriatric Nephrology
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Geriatric Nephrology
- 901 Geriatric Nephrology
Authors
- Yang, Dong Ho, CHA Bundang Medical Center, CHA Univ., Seongnam-si, Not Applicable, Korea (the Republic of)
- Lee, So-young, CHA Bundang Medical Center, CHA Univ., Seongnam-si, Not Applicable, Korea (the Republic of)
- Lee, Mi Jung, CHA Bundang Medical Center, CHA Univ., Seongnam-si, Not Applicable, Korea (the Republic of)
- Jeong, Hye yun, CHA Bundang Medical Center, Seongnam-si, Korea (the Republic of)
Background
It is well known that malnutrition is implicated with increased morbidity and mortality in end-stage renal disease (ESRD) patients. Therefore, exploring risk factors for malnutrition has clinical relevance in these patients. In the present study, we aimed to investigate the significant association between fluid overload, inflammation, and malnutrition in ESRD patients on hemodialysis (HD).
Methods
A cross-sectional study was undertaken in 76 prevalent HD patients in South Korea. Geriatric nutritional risk index (GNRI) was calculated to determine nutritional status. Ratio of extracellular water (ECW) to total body water (TBW) was measured to determine fluid overload using multi-frequency bioimpedance (Inbody S20, Biospace, Seoul, Korea). Independent association between variables and GNRI were tested by linear regression analyses.
Results
The mean age was 59.1 ± 13.4 years, and 44 patients (57.9%) were mean. The mean GNRI value was 97.2 ± 6.6 (median 97.8, interquartile range 94.4 to 101.8). The mean ratio of ECW to TBW (ECW/TBW) was 0.38 ± 0.02. In univariate analysis, age (per 1 year, ß=-0.13, 95% confidence interval [CI]=-0.24 to -0.02), ECW/TBW (per 0.01, ß=-1.89, 95% CI=-2.58 to -1.19), and C-reactive protein concentrations (per 1 mg/l, ß=-4.73, 95% CI=-7.19 to -2.28) were negatively associated with GNRI, while serum potassium (per 1 mEq/l, ß=2.46, 95% CI=0.36 to 4.55) and calcium-phosphorous products (per 1 mg2/dl2, ß=0.18, 95% CI=0.06 to 0.29) were positively associated with GNRI. Moreover, men and patients with previous cardiovascular disease history had lower GNRI values. Multivariate analysis demonstrated that higher values of ECW/TBW (per 0.01, ß=-1.33, 95% CI=-2.06 to -0.59) and C-reactive protein (per 1 mg/l, ß=-2.88, 95% CI=-5.07 to -0.68) were independently associated with lower GNRI values after adjustment of confounding variables.
Conclusion
Extracellular volume expansion and inflammation showed an independent association with lower GNRI values in HD patients. This result suggest that avoiding fluid overload and inflammation could be helpful to mitigate malnutrition in these patients.