title: C-reactive protein is a significant predictor of decrease in fat mass in hemodialysis patients.
abstract: Malnutrition and inflammation are common in hemodialysis patients, and are usually closely associated. We examined annual body fat mass changes, a possible nutritional parameter, in maintenance hemodialysis patients, and investigated the factors affecting such changes. Body fat mass of 454 hemodialysis patients (61+/-11 years, 269 males and 185 females) was measured twice by dual energy X-ray absorptiometry (DEXA), with a 12-month interval between measurements. In a total of 65 patients with hemodialysis duration of less than 1 year at the first measurement, fat mass at the second measurement had increased significantly over the course of a year (P<0.0001). In contrast, in a total of 389 patients with hemodialysis duration of more than 1 year at the first measurement, fat mass at the second measurement significantly decreased (P<0.005). In the 389 patients, significant negative correlations were seen between fat mass changes and CRP (r=-0.165, P<0.005). In a multiple regression analysis, CRP was a significant factor (beta=-0.163, P<0.005) affecting fat mass changes, independent of other confounding clinical factors (R(2)=0.127, P<0.001). These results show that body fat mass of long-term hemodialysis patients decreases after an initial increase in the first to second years of hemodialysis. In hemodialysis patients, fat mass change appears to be a parameter indicative of nutritional changes. Chronic inflammation, represented by higher CRP levels, is a significant factor affecting decrease in fat mass, and is related to poorer nutritional status.
authors.affiliation: Shirasagi Hospital Kidney Center, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fujino
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Senji
authors.initials: S
authors.lastname: Okuno
authors.forename: Naoki
authors.initials: N
authors.lastname: Tsuboniwa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maekawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Izumotani
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D001823:Body Composition; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein