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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MDPI AG
2021-05-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/6/1870 |
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| author | Ming-Tsun Tsai Wei-Cheng Tseng Shuo-Ming Ou Kuo-Hua Lee Chih-Yu Yang Der-Cherng Tarng |
| author_facet | Ming-Tsun Tsai Wei-Cheng Tseng Shuo-Ming Ou Kuo-Hua Lee Chih-Yu Yang Der-Cherng Tarng |
| author_sort | Ming-Tsun Tsai |
| collection | DOAJ |
| 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-α), 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. |
| first_indexed | 2024-03-10T10:52:39Z |
| format | Article |
| id | doaj.art-6bae9258f2a0450aac71d39fceb282f9 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T10:52:39Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-6bae9258f2a0450aac71d39fceb282f92023-11-21T22:06:57ZengMDPI AGNutrients2072-66432021-05-01136187010.3390/nu13061870Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis PatientsMing-Tsun Tsai0Wei-Cheng Tseng1Shuo-Ming Ou2Kuo-Hua Lee3Chih-Yu Yang4Der-Cherng Tarng5Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei 11217, TaiwanProtein-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-α), 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.https://www.mdpi.com/2072-6643/13/6/1870hemodialysisnutritional screeningprotein-energy wastingsimplified creatinine indexsystemic inflammation |
| spellingShingle | Ming-Tsun Tsai Wei-Cheng Tseng Shuo-Ming Ou Kuo-Hua Lee Chih-Yu Yang Der-Cherng Tarng Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients Nutrients hemodialysis nutritional screening protein-energy wasting simplified creatinine index systemic inflammation |
| title | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
| title_full | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
| title_fullStr | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
| title_full_unstemmed | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
| title_short | Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients |
| title_sort | comparison of simplified creatinine index and systemic inflammatory markers for nutritional evaluation of hemodialysis patients |
| topic | hemodialysis nutritional screening protein-energy wasting simplified creatinine index systemic inflammation |
| url | https://www.mdpi.com/2072-6643/13/6/1870 |
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