Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study
Nutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls....
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/15/24/5036 |
| _version_ | 1797379784379990016 |
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| author | Mar Ruperto Guillermina Barril |
| author_facet | Mar Ruperto Guillermina Barril |
| author_sort | Mar Ruperto |
| collection | DOAJ |
| description | Nutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls. A case–control study was conducted on 168 older participants (84 HD patients (cases) and 84 controls) age- and sex-matched. Demographic, clinical, anthropometric, and laboratory parameters were collected from medical records. The primary outcome was nutritional status assessment using a combination of nutritional and inflammatory markers along with the geriatric nutritional risk index (GNRI). Sarcopenic obesity (SO) was studied by the combined application of anthropometric measures. Body composition and hydration status were assessed by bioelectrical impedance analysis (BIA). Univariate and multivariate regression analyses were performed to identify nutritional and inflammatory independent risk indicators in elderly HD patients and controls. A significantly high prevalence of nutritional risk measured by the GNRI was found in HD patients (32.1%) compared to controls (6.0%) (<i>p</i> < 0.001). Elderly HD patients were overweight and had lower percent arm muscle circumference, phase angle (PA), serum albumin (s-albumin), as well as higher percent extracellular body water (ECW%) and serum C-reactive protein (s-CRP) than controls (all at least, <i>p</i> < 0.01). SO was higher in HD patients (15.50%) than in controls (14.30%). By multi-regression analyses, age < 75 years (OR: 0.119; 95%CI: 0.036 to 0.388), ECW% (OR: 1.162; 95%CI: 1.061 to 1.273), PA (OR: 0.099; 95%CI: 0.036 to 0.271), as well as BMI, s-albumin ≥ 3.8 g/dL, and lower s-CRP were independently related between cases and controls (all at least, <i>p</i> < 0.05). Elderly HD patients had increased nutritional risk, SO, inflammation, overhydration, and metabolic derangements compared to controls. This study highlights the importance of identifying nutritional risk along with inflammation profile and associated body composition disorders in the nutritional care of elderly HD patients. Further studies are needed to prevent nutritional disorders in elderly HD patients. |
| first_indexed | 2024-03-08T20:28:02Z |
| format | Article |
| id | doaj.art-74cefb33f20a4bb2ba20fdfe3cc738be |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-08T20:28:02Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
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| series | Nutrients |
| spelling | doaj.art-74cefb33f20a4bb2ba20fdfe3cc738be2023-12-22T14:29:54ZengMDPI AGNutrients2072-66432023-12-011524503610.3390/nu15245036Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control StudyMar Ruperto0Guillermina Barril1Department of Pharmaceutical & Health Sciences, School of Pharmacy, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Alcorcón, Madrid, SpainNephrology Department, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, SpainNutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls. A case–control study was conducted on 168 older participants (84 HD patients (cases) and 84 controls) age- and sex-matched. Demographic, clinical, anthropometric, and laboratory parameters were collected from medical records. The primary outcome was nutritional status assessment using a combination of nutritional and inflammatory markers along with the geriatric nutritional risk index (GNRI). Sarcopenic obesity (SO) was studied by the combined application of anthropometric measures. Body composition and hydration status were assessed by bioelectrical impedance analysis (BIA). Univariate and multivariate regression analyses were performed to identify nutritional and inflammatory independent risk indicators in elderly HD patients and controls. A significantly high prevalence of nutritional risk measured by the GNRI was found in HD patients (32.1%) compared to controls (6.0%) (<i>p</i> < 0.001). Elderly HD patients were overweight and had lower percent arm muscle circumference, phase angle (PA), serum albumin (s-albumin), as well as higher percent extracellular body water (ECW%) and serum C-reactive protein (s-CRP) than controls (all at least, <i>p</i> < 0.01). SO was higher in HD patients (15.50%) than in controls (14.30%). By multi-regression analyses, age < 75 years (OR: 0.119; 95%CI: 0.036 to 0.388), ECW% (OR: 1.162; 95%CI: 1.061 to 1.273), PA (OR: 0.099; 95%CI: 0.036 to 0.271), as well as BMI, s-albumin ≥ 3.8 g/dL, and lower s-CRP were independently related between cases and controls (all at least, <i>p</i> < 0.05). Elderly HD patients had increased nutritional risk, SO, inflammation, overhydration, and metabolic derangements compared to controls. This study highlights the importance of identifying nutritional risk along with inflammation profile and associated body composition disorders in the nutritional care of elderly HD patients. Further studies are needed to prevent nutritional disorders in elderly HD patients.https://www.mdpi.com/2072-6643/15/24/5036agingbioimpedance analysisbody compositioncase–control studyelderlygeriatric nutritional risk |
| spellingShingle | Mar Ruperto Guillermina Barril Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study Nutrients aging bioimpedance analysis body composition case–control study elderly geriatric nutritional risk |
| title | Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study |
| title_full | Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study |
| title_fullStr | Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study |
| title_full_unstemmed | Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study |
| title_short | Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients—A Case–Control Study |
| title_sort | clinical significance of nutritional status inflammation and body composition in elderly hemodialysis patients a case control study |
| topic | aging bioimpedance analysis body composition case–control study elderly geriatric nutritional risk |
| url | https://www.mdpi.com/2072-6643/15/24/5036 |
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