The nutritional and inflammatory evaluation in dialysis patients (NIED) study: Overview of the NIED study and the role of dietitians
The nutritional and inflammatory evaluation in dialysis patients (NIED) study: Overview of the NIED study and the role of dietitians
复制标题
DOI：
10.1053/j.jrn.2005.01.003
复制
发表时间：
2005-04-01
影响因子：
3.2
通讯作者：
Kalantar-Zadeh, K
中科院分区：
文献类型：
--
作者：
Colman, S;Bross, R;Kalantar-Zadeh, K
绝大多数维持性血液透析(MHD)患者在开始透析治疗后5年内死亡，主要死于心血管疾病。MHD患者死亡的最强和最常见的相关因素不是传统的心血管危险因素，而是蛋白质-能量营养不良和炎症的标志物，也称为营养不良-炎症复合体综合征(MICS)。矛盾的是，典型的危险因素，如肥胖和高胆固醇血症，与MHD患者更好的生存相关。有人假设，这种所谓的反向流行病学是由MHD患者中MICS的压倒性流行和主导作用引起的。因此，提高MHD患者存活率和生活质量的关键可能是更好地了解MICS及其与心血管疾病和预后的相互作用。透析患者的营养和炎症评估(NIED)研究是一项旨在检验这些假说的纵向多中心队列研究。在任何给定的半年一次的轮询中，来自洛杉矶地区8个DaVita透析设施的大约360名MHD患者被检查；900名MHD患者将在这项为期5年的前瞻性研究(2001年10月至2006年9月)结束时被累积研究。当患者在他们的透析设备中接受常规的HID治疗时，由10到12名透析单位的营养师重复测量营养状态和炎症的标志物。以全因死亡率、病死率、住院时间和生活质量作为结果指标进行研究。合作营养师是主要的评估者，在研究的各个方面都起着至关重要的作用。本文回顾了NIED研究的设计和基础设施，并报告了研究前12至30个月的初步结果。(C)2005年，由国家肾脏基金会公司提供。
The absolute majority of maintenance hemodialysis (MHD) patients die within 5 years of commencing dialysis treatment, mostly because of cardiovascular (CV) disease. The strongest and most common correlates of death in MHD patients are not conventional CV risk factors, but markers of protein-energy malnutrition and inflammation, together also known as malnutrition-inflammation complex syndrome (MICS). Paradoxically, classic risk factors such as obesity and hypercholesterolemia are associated with better survival in MHD patients. It has been hypothesized that this so-called reverse epidemiology is caused by the overwhelming prevalence and dominating effect of MICS in MHD patients. Hence, the key to improving survival and quality of life in MHD patients may be a better understanding of MICS and its interactions with CV disease and outcome. The Nutritional and Inflammatory Evaluation in Dialysis Patients (NIED) study is a longitudinal multicenter cohort study that aims to examine these hypotheses. At any given semiannual round, approximately 360 MHD patients from 8 DaVita dialysis facilities in the Los Angeles area are examined; 900 MHD patients will be cumulatively studied by the end of this 5-year prospective study (October 2001 to September 2006). Repeated measures of markers of nutritional status and inflammation are performed by 10 to 12 dialysis unit dietitians while patients attend their routine HID treatment in their dialysis facilities. All-cause and CV mortality, hospitalization, and quality of life are studied as outcome measures. The collaborating dietitians are the main evaluators and play crucial roles in all aspects of the study. This article reviews the design and infrastructure of the NIED study and reports preliminary findings of the first 12 to 30 months of the study. (c) 2005 by the National Kidney Foundation, Inc.