Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients
Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 3...
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| Veröffentlicht in: | Nutrients 2021-05, Vol.13 (6), p.1870, Article 1870 |
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| description | Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 +/- 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud's formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40-0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21-0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients. |
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This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 +/- 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud's formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40-0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21-0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu13061870</identifier><identifier>PMID: 34070850</identifier><language>eng</language><publisher>BASEL: Mdpi</publisher><subject>Blood pressure ; Body composition ; Body mass ; Body mass index ; Body size ; Cardiovascular disease ; Clinical nutrition ; Comparative analysis ; Creatinine ; Criteria ; Fat-free body mass ; Health care facilities ; Hemodialysis ; Immunoassay ; Infectious diseases ; Inflammation ; Interleukin 6 ; Interleukin 8 ; Interleukins ; Lean body mass ; Life Sciences & Biomedicine ; Malnutrition ; Medical research ; Medicine, Experimental ; Metabolism ; Mortality ; Multivariate analysis ; Musculoskeletal system ; Nutrition ; Nutrition & Dietetics ; Nutrition assessment ; Nutrition therapy ; nutritional screening ; Nutritional status ; Patients ; Physiological aspects ; protein-energy wasting ; Proteins ; Risk analysis ; Risk factors ; Sample size ; Science & Technology ; simplified creatinine index ; systemic inflammation ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α</subject><ispartof>Nutrients, 2021-05, Vol.13 (6), p.1870, Article 1870</ispartof><rights>COPYRIGHT 2021 MDPI AG</rights><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>19</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000667426700001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c516t-11a0c4b373e4f40726933abc756cb8edbd4b30ebedc5de3e5f592056432a171d3</citedby><cites>FETCH-LOGICAL-c516t-11a0c4b373e4f40726933abc756cb8edbd4b30ebedc5de3e5f592056432a171d3</cites><orcidid>0000-0002-8597-4132 ; 0000-0001-9017-2081 ; 0000-0002-6314-8788 ; 0000-0002-6940-9651 ; 0000-0001-9899-3159</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229044/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229044/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,39263,53796,53798</link.rule.ids></links><search><creatorcontrib>Tsai, Ming-Tsun</creatorcontrib><creatorcontrib>Tseng, Wei-Cheng</creatorcontrib><creatorcontrib>Ou, Shuo-Ming</creatorcontrib><creatorcontrib>Lee, Kuo-Hua</creatorcontrib><creatorcontrib>Yang, Chih-Yu</creatorcontrib><creatorcontrib>Tarng, Der-Cherng</creatorcontrib><title>Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients</title><title>Nutrients</title><addtitle>NUTRIENTS</addtitle><description>Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 +/- 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud's formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40-0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21-0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients.</description><subject>Blood pressure</subject><subject>Body composition</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiovascular disease</subject><subject>Clinical nutrition</subject><subject>Comparative analysis</subject><subject>Creatinine</subject><subject>Criteria</subject><subject>Fat-free body mass</subject><subject>Health care facilities</subject><subject>Hemodialysis</subject><subject>Immunoassay</subject><subject>Infectious diseases</subject><subject>Inflammation</subject><subject>Interleukin 6</subject><subject>Interleukin 8</subject><subject>Interleukins</subject><subject>Lean body mass</subject><subject>Life Sciences & Biomedicine</subject><subject>Malnutrition</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Metabolism</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Musculoskeletal system</subject><subject>Nutrition</subject><subject>Nutrition & Dietetics</subject><subject>Nutrition assessment</subject><subject>Nutrition therapy</subject><subject>nutritional screening</subject><subject>Nutritional status</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>protein-energy wasting</subject><subject>Proteins</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sample size</subject><subject>Science & Technology</subject><subject>simplified creatinine index</subject><subject>systemic inflammation</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumor necrosis factor-α</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNkk1v1DAQQCMEolXphV8QiQsCbXHs2EkuSNWq0JXKh1Q4WxNnvHhJ7MVOCnvirzPpVgtFHHAOccZvnjP2ZNnTgp0J0bBXfioEU0VdsQfZMWcVXyhViod_zI-y05Q2bB4Vq5R4nB2Jkqa1ZMfZz2UYthBdCj4PNr92w7Z31mGXLyPC6LzzmK98hz9y8F1-vUsjDs5QyPYwDDCGuMvfQfyKMeU2xPz9NEY3uuChzy9uoJ9g_pjdlziEzkG_Sy7lHymMfkxPskcW-oSnd--T7PObi0_Ly8XVh7er5fnVwshCjYuiAGbKVlQCS0s_z1UjBLSmksq0NXZtR4sMW-yM7FCgtLLhTFL1HIqq6MRJttp7uwAbvY1ugLjTAZy-DYS41hBHZ3rUqgVsuKwtB1ZKBmBmQWMNtrzmtiHX671rO7UD7Uh1ROjvSe-vePdFr8ONrjlvWFmS4PmdIIZvE6ZRDy4Z7HvwGKakuRSqVA0TjNBnf6GbMEU63Jkqy4YQOpQDtQYqwHkbaF8zS_V5pWSt6OIlUWf_oOjp5isNHq2j-L2EF_sEE0NKEe2hxoLpufv07-4j-OUe_o5tsMnQ9Ro8JFDzKVWVnMQ0CqLr_6eXbrztomWY_Ch-AVLj7KE</recordid><startdate>20210530</startdate><enddate>20210530</enddate><creator>Tsai, Ming-Tsun</creator><creator>Tseng, Wei-Cheng</creator><creator>Ou, Shuo-Ming</creator><creator>Lee, Kuo-Hua</creator><creator>Yang, Chih-Yu</creator><creator>Tarng, Der-Cherng</creator><general>Mdpi</general><general>MDPI AG</general><general>MDPI</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8597-4132</orcidid><orcidid>https://orcid.org/0000-0001-9017-2081</orcidid><orcidid>https://orcid.org/0000-0002-6314-8788</orcidid><orcidid>https://orcid.org/0000-0002-6940-9651</orcidid><orcidid>https://orcid.org/0000-0001-9899-3159</orcidid></search><sort><creationdate>20210530</creationdate><title>Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients</title><author>Tsai, Ming-Tsun ; 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This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 +/- 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud's formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40-0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21-0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. 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| subjects | Blood pressure Body composition Body mass Body mass index Body size Cardiovascular disease Clinical nutrition Comparative analysis Creatinine Criteria Fat-free body mass Health care facilities Hemodialysis Immunoassay Infectious diseases Inflammation Interleukin 6 Interleukin 8 Interleukins Lean body mass Life Sciences & Biomedicine Malnutrition Medical research Medicine, Experimental Metabolism Mortality Multivariate analysis Musculoskeletal system Nutrition Nutrition & Dietetics Nutrition assessment Nutrition therapy nutritional screening Nutritional status Patients Physiological aspects protein-energy wasting Proteins Risk analysis Risk factors Sample size Science & Technology simplified creatinine index systemic inflammation Tumor necrosis factor-TNF Tumor necrosis factor-α |
| title | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
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