RESUMEN
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.
Asunto(s)
Desnutrición Proteico-Calórica/complicaciones , Desnutrición Proteico-Calórica/diagnóstico , Desnutrición Proteico-Calórica/fisiopatología , Diálisis Renal , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapia , Anciano , Proteína C-Reactiva , Estudios Transversales , Impedancia Eléctrica , Femenino , Fuerza de la Mano/fisiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , EspañaAsunto(s)
Disreflexia Autónoma/complicaciones , Hipertensión Maligna/etiología , Traumatismos de la Médula Espinal/complicaciones , Retención Urinaria/complicaciones , Vías Aferentes/fisiopatología , Disreflexia Autónoma/diagnóstico , Disreflexia Autónoma/fisiopatología , Vértebras Cervicales/lesiones , Diagnóstico Diferencial , Urgencias Médicas , Humanos , Hipertensión Maligna/fisiopatología , Masculino , Cuadriplejía/etiología , Fracturas de la Columna Vertebral/complicaciones , Fracturas de la Columna Vertebral/cirugía , Fusión Vertebral , Evaluación de Síntomas , Vejiga Urinaria/inervación , Cateterismo Urinario , Retención Urinaria/fisiopatología , Retención Urinaria/terapia , Adulto JovenRESUMEN
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