Relationship between the degree of malnutrition and echocardiographic parameters in hemodialysis patients.
BACKGROUND
The aim of this study is to investigate the relationship between the degree of malnutrition and inadequate volume control evidenced by echocardiography.


METHODS
In this study 72 chronic hemodialysis patients were investigated in a cross-sectional manner. The malnutrition score was calculated using Subjective Global Assessment. M-mode echocardiography was performed in all patients.


RESULTS
The highest malnutrition score (23.2 +/- 1.5 points) and lowest vena cava inferior collapse index (35 +/- 2%) were observed in the eccentric left ventricular hypertrophy group. The malnutrition index was found to be in positive relationship with the left atrium diameter and index, left ventricular mass and index, and left ventricular end-diastolic diameter. On the other hand, a negative correlation was detected with the vena cava inferior collapse index. When all parameters that were found to be related to malnutrition were assessed by multivariate analyses, a statistically significant relation was found between the left ventricular end-diastolic diameter and the malnutrition index.


CONCLUSIONS
The results of our study show that the progressive worsening of the nutritional status follows a parallel course along with the deterioration in the echocardiographic parameters concerning hypervolemia. This in turn suggests that increasing degrees of malnutrition are associated with more profound derangements in the volume status. Volume excess might be a mechanism explaining the increased mortality and morbidity caused by malnutrition in hemodialysis patients. Owing to its cross-sectional design, this study cannot provide unequivocal evidence regarding the cause and effect relationship between volume overload and malnutrition in hemodialysis patients.
Kürşat
Seyhun
S
Department of Nephrology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey. seyhun.kursat@bayar.edu.tr
Tekçe
Hikmet
H
Ekmekçi
Cenk
C
Colak
Hülya Bahadir
HB
Alici
Tamer
T
D015897:Comorbidity; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D014421:Turkey / Q000453:epidemiology; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology
D012709:Serum Albumin