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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Kidney+J
2017 ; 10
(2
): 170-175
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Low lean tissue mass is an independent risk factor for mortality in patients with
stages 4 and 5 non-dialysis chronic kidney disease
#MMPMID28396734
Vega A
; Abad S
; Macías N
; Aragoncillo I
; Santos A
; Galán I
; Cedeño S
; Manuel López-Gómez J
Clin Kidney J
2017[Apr]; 10
(2
): 170-175
PMID28396734
show ga
Background: Mortality in patients with stages 4 and 5 chronic kidney disease
(CKD) is higher than in the general population. Body composition predicts
mortality. Our objective was to evaluate the effect of body composition on
mortality in patients with stages 4 and 5 non-dialysis CKD. Methods: We performed
a prospective study of 356 patients with stages 4 and 5 non-dialysis CKD. At
baseline, we recorded general characteristics, history of cardiovascular events,
body composition, serum inflammatory markers, nutrition and cardiac biomarkers.
Body composition was analysed using bioimpedance spectroscopy. We recorded the
lean tissue index (LTI), fat tissue index (FTI) and overhydration (OH). During a
median (range) follow-up of 22 (3-49) months, we recorded mortality,
cardiovascular events and progress to renal replacement therapy. Results: At
baseline, mean (± standard deviation) age was 67?±?13 years (men 64%; diabetes
36%). Mean body mass index was 28.2?±?12.8?kg/m(2), the FTI was
12.3?±?5.6?kg/m(2), the LTI was 15.7?±?3.4?kg/m(2) and median (interquartile
range) OH was 0.6 (-0.4 to 1.5) L. Sixty-four (18%) patients died during
follow-up. The univariate Cox analysis showed an association between mortality
and age, low LTI, high Charlson comorbidity index, previous cardiovascular
events, OH, low albumin and prealbumin levels, and high C-reactive protein
levels. Kaplan-Meier analysis revealed higher survival in patients with a higher
LTI (log-rank, 9.47; P?=?0.002). The multivariate Cox analysis confirmed an
association between mortality and low LTI (P?=?0.031), previous cardiovascular
events (P?=?0.003) and high Charlson comorbidity index (P?=?0.01). We did not
find any association between body composition and cardiovascular events or renal
replacement therapy. Conclusions: A low LTI is an independent factor for
mortality in patients with stages 4 and 5 CKD.