title: Body composition monitor assessing malnutrition in the hemodialysis population independently predicts mortality.
abstract: OBJECTIVE
  Malnutrition is a known predictor of mortality in the general and hemodialysis populations. However, diagnosing malnutrition in dialysis patients remains problematic. Body composition monitoring (BCM) is currently used mainly for assessing overhydratation in hemodialysis patients, but it also offers the possibility of evaluating nutrition status. This study explored whether malnutrition diagnosed by BCM predicts mortality at up to 54 months follow-up in prevalent hemodialysis patients.
  
  
  METHODS
  This was a retrospective epidemiology cohort study. Dialysis patients with baseline BCM measurement between 2008 and 2013 were enrolled. The observation period was up to 54 months follow-up.
  
  
  METHODS
  A total sample consisted of 960 chronic hemodialysis participants.
  
  
  METHODS
  All data were retrieved from medical records. Nutrition status was estimated by BCM; malnutrition was diagnosed as lean tissue index less than 10% of the normal value.
  
  
  METHODS
  Cox regression was performed to identify whether low LTI predicted mortality in hemodialysis patients.
  
  
  RESULTS
  BCM-diagnosed malnutrition (hazard ratio [HR] 1.66; 95% confidence interval [CI] 1.1; 2.44), higher age (HR 1.05; 95% CI 1.03; 1.07), longer dialysis vintage (HR 1.00; 95% CI 1.00; 1.00), central venous catheter use (HR 1.96; 95% CI 1.28; 2.99), and low serum albumin (HR 0.91; 95% CI 0.87; 0.95) contributed significantly to the Cox regression model on mortality.
  
  
  CONCLUSIONS
  BCM-diagnosed malnutrition in chronic hemodialysis patients is an independent predictor of mortality at up to 54 months follow-up and is associated with a 1.66-fold higher risk of dying compared with normal nutrition status. Whether intervention (e.g., nutritional supplementation) might improve nutrition and reduce the higher risk of mortality in malnutrition patients on hemodialysis remains a challenge for future research.
authors.affiliation: Fresenius Medical Care, Dialysis Services, Piestany, Slovak Republic; Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, Kosice, Piestany, Slovak Republic; Institute of Public Health, Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Piestany, Slovak Republic. Electronic address: rosenberger_jaro@hotmail.com.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.affiliation: Internal Clinic, Teaching Hospital Nitra, Nitra, Slovak Republic.
authors.forename: Viera
authors.initials: V
authors.lastname: Kissova
authors.affiliation: Fresenius Medical Care, Dialysis Services, Piestany, Slovak Republic; Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, Kosice, Piestany, Slovak Republic.
authors.forename: Maria
authors.initials: M
authors.lastname: Majernikova
authors.affiliation: Fresenius Medical Care, Dialysis Services, Piestany, Slovak Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Straussova
authors.affiliation: Fresenius Medical Care, Dialysis Services, Piestany, Slovak Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Boldizsar
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies