Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/42394
Title: Diagnostic usefulness of the protein energy wasting score in prevalent hemodialysis patients
Authors: Antón-Pérez, Gloria
Santana-del-Pino, Angelo 
Henríquez-Palop, Fernando
Monzón, Tania
Sánchez, Ana Y.
Valga, Francisco
Morales-Umpierrez, Adelaida
García-Cantón, Cesar 
Rodríguez-Pérez, Jose C. 
Carrero, Juan J.
UNESCO Clasification: 320506 Nefrología
120903 Análisis de datos
240401 Bioestadística
Keywords: Chronic Kidney-Disease
Subjective Global Assessment
Nutritional-Status
Anthropometric Parameters
Mortality, et al
Issue Date: 2018
Publisher: 1051-2276
Journal: Journal of Renal Nutrition 
Abstract: Objective To study whether the score proposed by the International Society of Renal Nutrition and Metabolism to define the protein energy wasting (PEW) syndrome has diagnostic validity in patients undergoing dialysis. Design and methods Cross-sectional study including 468 prevalent hemodialysis patients from Canary Islands, Spain. Individual PEW syndrome criteria and the number of PEW syndrome categories were related to other objective markers of PEW using linear and logistic regression analyses: subjective global assessment, handgrip strength, bioimpedance-assessed body composition, and levels of high-sensitivity C-reactive protein. Results Study participants (34% women) had a median age of 66 years, 37 months of maintenance dialysis, and 50% were diabetics. About 23% of patients had PEW (≥3 PEW categories), and 68% were at risk of PEW (1-2 PEW categories). Low prealbumin was the most frequently found derangement (52% of cases), followed by low albumin (46%), and low protein intake (35%). Across higher number of PEW syndrome categories, patients showed a longer dialysis vintage and had lower creatinine, triglycerides, and transferrin (P for trend < .001 for all). All nutritional assessments not included in the PEW definition worsened across higher number of PEW categories. In multivariable regression analyses, there was a linear inverse relationship between muscle and fat mass as well as handgrip strength with the number of PEW syndrome categories. Likewise, the proportion of subjective global assessment-defined malnutrition and serum concentration of C-reactive protein gradually increased despite adjustment for confounders (P for trend < .05 for all). Conclusion The PEW score reflects systemic inflammation, malnutrition and wasting among dialysis patients and may thus be used for diagnostic purposes.
URI: http://hdl.handle.net/10553/42394
ISSN: 1051-2276
DOI: 10.1053/j.jrn.2018.05.002
Source: Journal of Renal Nutrition[ISSN 1051-2276],v. 28, p. 428-434
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