Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients?

David P. Murray, Lufei Young, Jennifer L Waller, Stephanie M Wright, Rhonda Colombo, Stephanie Baer, Vanessa Spearman, Rosalia Garcia-Torres, Kori Williams, Mufaddal Kheda, Norris Stanley Nahman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: High mortality in dialysis patients may be associated with protein-energy wasting (PEW) syndrome characterized by progressively depleted protein and energy stores. While early diagnosis and treatment of PEW can reduce mortality, clinically practical measures for its detection are lacking. Poor dietary protein intake (DPI) is associated with risk of malnutrition and PEW. However, the impact of DPI on mortality is unclear. The purpose of this study is to examine the ability of DPI to predict 1-year mortality in dialysis patients. Methods: This prospective, secondary study using data from the Comprehensive Dialysis Study and United States Renal Data System examined risk factors associated with 1-year mortality in dialysis patients. Results: Seventeen (7.5%) of the 227 subjects died within 1 year following baseline data collection. One year survivors were significantly younger (60 ± 13.6 versus 71 ± 12.8; P = 0.0043), had a lower Charlson Comorbidity Index score (1.6 ± 2.3 versus 4.0 ± 3.6; P = 0.0157), higher serum albumin level (3.5 ± 0.5 versus 3.3 ± 0.4; P = 0.0173) and had higher DPI (63 ± 33.7 versus 49.5 ± 21.5 g/day; P = 0.0386) than those who died. In multivariable Cox proportional hazards model analyses, only the Charlson Comorbidity Index adjusted hazard ratio for death (1.24) was significantly associated with increased mortality. The Comprehensive Dialysis Study data showed no association between DPI and 1-year mortality in dialysis patients. Conclusions: Future studies using more precise measures should further examine the impact of DPI on mortality given the known association of DPI with PEW syndrome and the definitive link between PEW syndrome and survival in dialysis patients.

Original languageEnglish (US)
Pages (from-to)234-243
Number of pages10
JournalAmerican Journal of the Medical Sciences
Volume356
Issue number3
DOIs
StatePublished - Sep 1 2018

Fingerprint

Dietary Proteins
Dialysis
Mortality
Wasting Syndrome
Comorbidity
Proteins
Protein-Energy Malnutrition
Proportional Hazards Models
Information Systems
Serum Albumin
Survivors
Early Diagnosis
Prospective Studies
Kidney
Survival

Keywords

  • Dialysis
  • Dietary protein intake
  • Mortality
  • Protein energy wasting

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients? / Murray, David P.; Young, Lufei; Waller, Jennifer L; Wright, Stephanie M; Colombo, Rhonda; Baer, Stephanie; Spearman, Vanessa; Garcia-Torres, Rosalia; Williams, Kori; Kheda, Mufaddal; Nahman, Norris Stanley.

In: American Journal of the Medical Sciences, Vol. 356, No. 3, 01.09.2018, p. 234-243.

Research output: Contribution to journalArticle

Murray, David P. ; Young, Lufei ; Waller, Jennifer L ; Wright, Stephanie M ; Colombo, Rhonda ; Baer, Stephanie ; Spearman, Vanessa ; Garcia-Torres, Rosalia ; Williams, Kori ; Kheda, Mufaddal ; Nahman, Norris Stanley. / Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients?. In: American Journal of the Medical Sciences. 2018 ; Vol. 356, No. 3. pp. 234-243.
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abstract = "Background: High mortality in dialysis patients may be associated with protein-energy wasting (PEW) syndrome characterized by progressively depleted protein and energy stores. While early diagnosis and treatment of PEW can reduce mortality, clinically practical measures for its detection are lacking. Poor dietary protein intake (DPI) is associated with risk of malnutrition and PEW. However, the impact of DPI on mortality is unclear. The purpose of this study is to examine the ability of DPI to predict 1-year mortality in dialysis patients. Methods: This prospective, secondary study using data from the Comprehensive Dialysis Study and United States Renal Data System examined risk factors associated with 1-year mortality in dialysis patients. Results: Seventeen (7.5{\%}) of the 227 subjects died within 1 year following baseline data collection. One year survivors were significantly younger (60 ± 13.6 versus 71 ± 12.8; P = 0.0043), had a lower Charlson Comorbidity Index score (1.6 ± 2.3 versus 4.0 ± 3.6; P = 0.0157), higher serum albumin level (3.5 ± 0.5 versus 3.3 ± 0.4; P = 0.0173) and had higher DPI (63 ± 33.7 versus 49.5 ± 21.5 g/day; P = 0.0386) than those who died. In multivariable Cox proportional hazards model analyses, only the Charlson Comorbidity Index adjusted hazard ratio for death (1.24) was significantly associated with increased mortality. The Comprehensive Dialysis Study data showed no association between DPI and 1-year mortality in dialysis patients. Conclusions: Future studies using more precise measures should further examine the impact of DPI on mortality given the known association of DPI with PEW syndrome and the definitive link between PEW syndrome and survival in dialysis patients.",
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T1 - Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients?

AU - Murray, David P.

AU - Young, Lufei

AU - Waller, Jennifer L

AU - Wright, Stephanie M

AU - Colombo, Rhonda

AU - Baer, Stephanie

AU - Spearman, Vanessa

AU - Garcia-Torres, Rosalia

AU - Williams, Kori

AU - Kheda, Mufaddal

AU - Nahman, Norris Stanley

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N2 - Background: High mortality in dialysis patients may be associated with protein-energy wasting (PEW) syndrome characterized by progressively depleted protein and energy stores. While early diagnosis and treatment of PEW can reduce mortality, clinically practical measures for its detection are lacking. Poor dietary protein intake (DPI) is associated with risk of malnutrition and PEW. However, the impact of DPI on mortality is unclear. The purpose of this study is to examine the ability of DPI to predict 1-year mortality in dialysis patients. Methods: This prospective, secondary study using data from the Comprehensive Dialysis Study and United States Renal Data System examined risk factors associated with 1-year mortality in dialysis patients. Results: Seventeen (7.5%) of the 227 subjects died within 1 year following baseline data collection. One year survivors were significantly younger (60 ± 13.6 versus 71 ± 12.8; P = 0.0043), had a lower Charlson Comorbidity Index score (1.6 ± 2.3 versus 4.0 ± 3.6; P = 0.0157), higher serum albumin level (3.5 ± 0.5 versus 3.3 ± 0.4; P = 0.0173) and had higher DPI (63 ± 33.7 versus 49.5 ± 21.5 g/day; P = 0.0386) than those who died. In multivariable Cox proportional hazards model analyses, only the Charlson Comorbidity Index adjusted hazard ratio for death (1.24) was significantly associated with increased mortality. The Comprehensive Dialysis Study data showed no association between DPI and 1-year mortality in dialysis patients. Conclusions: Future studies using more precise measures should further examine the impact of DPI on mortality given the known association of DPI with PEW syndrome and the definitive link between PEW syndrome and survival in dialysis patients.

AB - Background: High mortality in dialysis patients may be associated with protein-energy wasting (PEW) syndrome characterized by progressively depleted protein and energy stores. While early diagnosis and treatment of PEW can reduce mortality, clinically practical measures for its detection are lacking. Poor dietary protein intake (DPI) is associated with risk of malnutrition and PEW. However, the impact of DPI on mortality is unclear. The purpose of this study is to examine the ability of DPI to predict 1-year mortality in dialysis patients. Methods: This prospective, secondary study using data from the Comprehensive Dialysis Study and United States Renal Data System examined risk factors associated with 1-year mortality in dialysis patients. Results: Seventeen (7.5%) of the 227 subjects died within 1 year following baseline data collection. One year survivors were significantly younger (60 ± 13.6 versus 71 ± 12.8; P = 0.0043), had a lower Charlson Comorbidity Index score (1.6 ± 2.3 versus 4.0 ± 3.6; P = 0.0157), higher serum albumin level (3.5 ± 0.5 versus 3.3 ± 0.4; P = 0.0173) and had higher DPI (63 ± 33.7 versus 49.5 ± 21.5 g/day; P = 0.0386) than those who died. In multivariable Cox proportional hazards model analyses, only the Charlson Comorbidity Index adjusted hazard ratio for death (1.24) was significantly associated with increased mortality. The Comprehensive Dialysis Study data showed no association between DPI and 1-year mortality in dialysis patients. Conclusions: Future studies using more precise measures should further examine the impact of DPI on mortality given the known association of DPI with PEW syndrome and the definitive link between PEW syndrome and survival in dialysis patients.

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KW - Mortality

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