PloS one, 2019-05, Vol.14 (5), p.e0216415-e0216415
2019
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- Autor(en) / Beteiligte
- Titel
- Malnutrition, inflammation, progression of vascular calcification and survival: Inter-relationships in hemodialysis patients
- Ist Teil von
- PloS one, 2019-05, Vol.14 (5), p.e0216415-e0216415
- Ort / Verlag
- United States: Public Library of Science
- Erscheinungsjahr
- 2019
- Quelle
- Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
- Beschreibungen/Notizen
- Malnutrition and inflammation are closely linked to vascular calcification (VC), the severity of which correlate with adverse outcome. However, there were few studies on the interplay between malnutrition, inflammation and VC progression, rather than VC presence per se. We aimed to determine the relationship of malnutrition, inflammation, abdominal aortic calcification (AAC) progression with survival in hemodialysis (HD) patients. Malnutrition and inflammation were defined as low serum albumin (< 40 g/L) and high hs-CRP (≥ 28.57 nmol/L), respectively. We defined AAC progression as an increase in AAC score using lateral lumbar radiography at both baseline and one year later. Patients were followed up to investigate the impact of AAC progression on all-cause and cardiovascular mortality. AAC progressed in 54.6% of 97 patients (mean age 58.2±11.7 years, 41.2% men) at 1-year follow-up. Hypoalbuminemia (Odds ratio 3.296; 95% confidence interval 1.178-9.222), hs-CRP (1.561; 1.038-2.348), low LDL-cholesterol (0.976; 0.955-0.996), and the presence of baseline AAC (10.136; 3.173-32.386) were significant risk factors for AAC progression. During the mean follow-up period of 5.9 years, 38(39.2%) patients died and 27(71.0%) of them died of cardiovascular disease. Multivariate Cox regression analysis adjusted for old age, diabetes, cardiovascular history, and hypoalbuminemia determined that AAC progression was an independent predictor of all-cause mortality (2.294; 1.054-4.994). Malnutrition and inflammation were significantly associated with AAC progression. AAC progression is more informative than AAC presence at a given time-point as a predictor of all-cause mortality in patients on maintenance HD.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1932-6203eISSN: 1932-6203DOI: 10.1371/journal.pone.0216415Titel-ID: cdi_plos_journals_2219680498
- Format
- –
- Schlagworte
- Abdomen, Adult, Aged, Aged, 80 and over, Albumin, Aorta, Aorta, Abdominal - diagnostic imaging, Biology and Life Sciences, Blood cholesterol, Body mass index, Calcification, Calcification (ectopic), Calcification (Physiology), Cardiovascular diseases, Care and treatment, Cholesterol, Confidence intervals, Coronary vessels, Development and progression, Diabetes mellitus, Dialysis, Disease Progression, Disease-Free Survival, Enrollments, Fatalities, Female, Follow-Up Studies, Health aspects, Health risks, Hemodialysis, Hemodialysis patients, Hospitals, Humans, Inflammation, Inflammation - diagnostic imaging, Inflammation - mortality, Inflammation - therapy, Internal medicine, Kidney diseases, Low density lipoprotein, Low density lipoproteins, Male, Malnutrition, Malnutrition - complications, Malnutrition - diagnostic imaging, Malnutrition - mortality, Malnutrition - therapy, Medical research, Medicine, Medicine and Health Sciences, Metabolism, Middle Aged, Mortality, Nephrology, Obesity, Patient outcomes, Peritoneal dialysis, Physical Sciences, Prospective Studies, Radiography, Regression analysis, Renal Dialysis, Risk analysis, Risk factors, Serum albumin, Statistical analysis, Studies, Survival, Survival Rate, Transplants & implants, Vascular Calcification - diagnostic imaging, Vascular Calcification - etiology, Vascular Calcification - mortality, Vascular Calcification - therapy, Veins & arteries, Venture capital