Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)
Independent and Joint Associations of Nutritional Status Indicators With Mortality Risk Among Chronic Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)
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DOI：
10.1053/j.jrn.2009.10.002
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发表时间：
2010-07-01
影响因子：
3.2
通讯作者：
Port, Friedrich K.
中科院分区：
文献类型：
--
作者：
Lopes, Antonio Alberto;Bragg-Gresham, Jennifer L.;Port, Friedrich K.
目的：为了考虑肾脏疾病结果质量倡议对维持性血液透析患者使用多种营养测量方法的建议，我们探索了12个国家治疗的维持性血液透析患者中营养指标与死亡风险的独立和联合关联的数据。地点：7个欧洲国家、美国、加拿大、澳大利亚、新西兰和日本的透析单位。主要结果：死亡风险。方法：我们进行了一项前瞻性队列研究，从透析结果和实践模式研究(1996-2008)的第一阶段到第三阶段的40950名患者。结果：营养指标(血肌酐、血清白蛋白、标准化蛋白分解率、体重指数[BMI])对死亡风险的独立和联合作用(交互作用)经COX回归分析，调整了人口统计学、透析年限和合并症。每个指标评估的营养状况较差与各地区较高的死亡风险独立相关。显著的乘性交互作用(每个p
Objective: To consider the Kidney Disease Outcomes Quality Initiative recommendation of using multiple nutritional measurements for patients on maintenance dialysis, we explored data for independent and joint associations of nutritional indicators with mortality risk among maintenance hemodialysis patients treated in 12 countries.Setting: Dialysis units in seven European countries, the United States, Canada, Australia, New Zealand, and Japan.Main Outcome: Mortality risk.Methods: We conducted a prospective cohort study of 40,950 patients from phases I to III of the Dialysis Outcomes and Practice Patterns Study (1996-2008). Independent and joint effects (interactions) of nutritional indicators (serum creatinine, serum albumin, normalized protein catabolic rate, body mass index [BMI]) on mortality risk were assessed by Cox regression with adjustments for demographics, years on dialysis, and comorbidities.Results: Important variations in nutritional indicators were seen by country and patient characteristics. Poorer nutritional status assessed by each indicator was independently associated with higher mortality risk across regions. Significant multiplicative interactions (each p