Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS.

Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Research Abstract Details 

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Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Abstract Text:

Antonio Alberto Lopes,Stacey J Elder,Nancy Ginsberg,Vittorio E Andreucci, Cruz,Shunichi Fukuhara,Donna L Mapes,Akira Saito,Ronald L Pisoni,Rajiv Saran,Friedrich K Port,

BACKGROUND: Identification of haemodialysis patients with problems related to lack of appetite should help prevent adverse outcomes. We studied whether a single question about being bothered by lack of appetite within the prior 4 weeks is related to nutritional status, inflammation and risks of death and hospitalization. Additionally, we assessed associations of lack of appetite with depression, dialysis dose and length of haemodialysis. METHODS: This study is an analysis of baseline and longitudinal data from 14 406 patients enrolled in the Dialysis Outcomes and Practice Pattern Study. Cox regression was used to assess whether the degree (not, somewhat, moderately, very much, extremely) that patients were bothered by lack of appetite is an independent predictor of death and hospitalization. Logistic regression was used to identify baseline characteristics associated with being bothered by lack of appetite. RESULTS: The risk of death was more than 2-fold higher [relative risk (RR) = 2.23; 95% confidence interval (CI) = 1.90-2.62] and the risk of hospitalization 33% higher (RR = 1.33; 95% CI = 1.19-1.48) among patients extremely bothered, compared with not bothered, by lack of appetite. These associations followed a dose-response fashion and remained statistically significant after adjustments for 14 comorbidities. Depression, shorter haemodialysis session, hypoalbuminaemia, lower concentration of serum creatinine and normalized protein catabolic rate, lower body mass index and higher leucocyte and neutrophil counts were independently associated with higher odds of being bothered by lack of appetite. CONCLUSIONS: The data suggest that a single question about lack of appetite helps identify haemodialysis patients with poorer nutritional status, inflammation, depression and higher risks of hospitalization and death. The study calls attention to a possible beneficial effect of longer haemodialysis on appetite.

Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Publishing Authors By Initials

AA Lopes,SJ Elder,N Ginsberg,VE Andreucci,JM Cruz,S Fukuhara,DL Mapes,A Saito,RL Pisoni,R Saran,FK Port,

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Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Nephrology, dialysis, transplantation : official p

VOLUME: 22

Page Numbers: 3538-46

Journal Abbreviation: Nephrol. Dial. Transplant.

ISSN: 0931-0509

DAY: 24

MONTH: 09

YEAR: 2007

Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Information

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LANGUAGE: eng

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AFFILIATION: MS, Arbor Research Collaborative for Health, 315 W. Huron, Suite 360, Ann Arbor, MI 48103, USA. friedrich.port@ArborResearch.org.

Country: England

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MEDLINETA: Nephrol Dial Transplant

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