Dietary intake as a predictor for all-cause mortality in hemodialysis subjects (NUGE-HD study)


Autoři: Karla Pereira Balbino aff001;  Leidjaira Lopes Juvanhol aff001;  Andreza de Paula Santos Epifânio aff001;  Luciane Domingos Marota aff002;  Josefina Bressan aff001;  Helen Hermana Miranda Hermsdorff aff001
Působiště autorů: Department of Nutrition and Health. Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil aff001;  Division of Nephrology, São João Batista Hospital, Viçosa, Minas Gerais, Brazil aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226568

Souhrn

This study aimed to identify the factors capable of mortality prediction in patients on hemodialysis, using a prospective cohort with three years of follow-up. We hypothesized that lack of clinical-metabolic control, impairment of nutritional status, and inadequate food consumption are risk factors for mortality in this population. This is a longitudinal study on a non-probabilistic sample of 85 adults and elderly patients undergoing hemodialysis, aged ≥ 18 years (66.0% male, 61.6±13.7 years). Data on anthropometric, biomarkers, body composition and food intake were obtained. Predictors of mortality were evaluated using Cox regression analysis. During the three years follow-up, 16 patients (18.8%) died. We observed that age (HR = 1.319, CI 95% = 1.131–1.538), calcium-phosphorus product (HR = 1.114, CI 95% = 1.031–1.205), ferritin (HR = 1.001, CI 95% = 1.001–1.002), nitric oxide (HR = 1.082, CI 95% = 1.006–1.164), and vitamin C intake (HR = 1.005, CI 95% = 1.001–1.009) were positively associated with mortality. Serum iron (HR = 0.717, CI 95% = 0.567–0.907), triceps skinfold thickness (HR = 0.704, CI 95% = 0.519–0.954), lean mass (HR = 0.863, CI 95% = 0.787–0.945), and the ratio of dietary monounsaturated/polyunsaturated fat (HR = 0.022, CI 95% = 0.001–0.549) were independent negative predictors of mortality. Our results suggest that dietary intake is also a predictor of mortality in patients on hemodialysis, besides nutritional status, body composition, oxidative stress, inflammation, and bone metabolism, indicating the importance of evaluation of these factors altogether for better prognosis.

Klíčová slova:

Bone and mineral metabolism – Fats – Ferritin – Food consumption – Inflammation – Medical dialysis – Medical risk factors – vitamin C


Zdroje

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2019 Číslo 12