Appetite course over time and the risk of death in patients on chronic hemodialysis.
OBJECTIVE
Appetite in patients on chronic hemodialysis (HD) may be constantly very good/good or fair/poor or may fluctuate up and down over time. When constantly fair/poor, appetite has been shown to be associated with older age, more comorbidities, and more hospitalizations; however, it is unknown if it predicts survival. The aim of the present study was to assess appetite monthly for 6 months in patients on chronic HD and to determine if the course of appetite over time predicts mortality.


METHODS
Ninety-two HD patients were evaluated at baseline for appetite, nutritional and inflammatory markers, comorbid conditions, and Charlson's comorbidity index. Appetite assessment was repeated monthly for 6 consecutive months. Survival in relation with the course of appetite over time was determined.


RESULTS
Appetite was constantly very good/good in 45 patients (Group 1), fair/poor/very poor in 30 (Group 2), and fluctuated in 17 (Group 3). Twenty-seven (29.3 %) patients died after a mean period of 28 ± 13 months. Overall, the mean survival time was 42.1 ± 1.2 months. For Groups 1, 2, and 3, the mean survival time was 46.1 ± 0.92, 37.9 ± 2.5, and 39.1 ± 3.7 months, respectively (p < 0.0001). After multivariate logistic regression analysis, the course of appetite over time was not found to be an independent risk factor for mortality.


CONCLUSIONS
The course of appetite over time does not seem to predict mortality in patients on chronic hemodialysis. Considering that the study included a relatively small number of patients, larger similar studies are desirable.
Hemodialysis Service, Department of Surgery, Università Cattolica del Sacro Cuore di Roma, Largo A. Gemelli 8, 00168, Rome, Italy. maubosso@tin.it
Maurizio
M
Bossola
Enrico
E
Di Stasio
Fausto
F
Rosa
Loredana
L
Dominici
Manuela
M
Antocicco
Costanza
C
Pazzaglia
Irene
I
Aprile
Luigi
L
Tazza
D000328:Adult; D000367:Age Factors; D000368:Aged; D001066:Appetite; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000379:methods / Q000401:mortality*; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors