title: A simple protein-energy wasting score predicts survival in maintenance hemodialysis patients.
abstract: OBJECTIVE
  Nutritional status is a powerful predictor of survival in maintenance hemodialysis patients but remains challenging to assess. We defined a new Protein Energy Wasting (PEW) score based on the nomenclature proposed by the International Society of Renal Nutrition and Metabolism in 2008.
  
  
  METHODS
  This score, graded from 0 (worse) to 4 (best) was derived from 4 body nutrition compartments: serum albumin, body mass index, a normalized serum creatinine value, and protein intake as assessed by nPNA.
  
  
  METHODS
  We applied this score to 1443 patients from the ARNOS prospective dialysis cohort and provide survival data from 2005 until 2008.
  
  
  METHODS
  Patients survival at 3.5 year.
  
  
  RESULTS
  Survival ranged from 84%-69% according to the protein-energy wasting score. There was a clear-cut reduction in survival (5%-7%; P < 0.01) for each unit decrement in the score grade. There was a 99% survival at 1 year for patients with the score of 4. In addition, the 6-month variation of this PEW score also strongly predicted patients' survival (P < 0.01).
  
  
  CONCLUSIONS
  A new simple and easy-to-get PEW score predicts survival in maintenance hemodialysis patients. Furthermore, increase of this nutritional score over time also indicates survival improvement, and may help to better identify subgroups of patients with a high mortality rate, in which nutrition support should be enforced.
authors.affiliation: Centre de dialyse Porte de Provence, AGDUC, Montélimar, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Moreau-Gaudry
authors.affiliation: Centre du Rein Artificiel - Nephrocare, Ste Foy les Lyon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jean
authors.affiliation: Department of Nephrology, CarMeN, CENS, Centre Hospitalier Lyon-Sud, Université de Lyon F-69622, France.
authors.forename: Leslie
authors.initials: L
authors.lastname: Genet
authors.affiliation: Service de néphrologie et hémodialyse, Centre Hospitalier - Avitum, Sallanches, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Lataillade
authors.affiliation: Service de néphrologie et hémodialyse, Centre hospitalier, Annonay, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Legrand
authors.affiliation: Centre de dialyse des Eaux Claires, AGDUC, Grenoble, France.
authors.forename: François
authors.initials: F
authors.lastname: Kuentz
authors.affiliation: Department of Nephrology, CarMeN, CENS, Centre Hospitalier Lyon-Sud, Université de Lyon F-69622, France. Electronic address: denis.fouque@chu-lyon.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002100:Cachexia / Q000209:etiology / Q000473:pathology*; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000473:pathology*; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D012709:Serum Albumin; D003404:Creatinine