Low protein nitrogen appearance as a surrogate of low dietary protein intake is associated with higher all-cause mortality in maintenance hemodialysis patients

Journal of Nutrition

Volumn 143, Issue 7, 2013, Pages 1084-1092

  Ravel, Vanessa A ^a,b   Molnar, Miklos Z ^a,c,d   Streja, Elani ^a,b   Kim, Jun Chul ^a   Victoroff, Alla ^a,b   Jing, Jennie ^a   Benner, Debbie ^e   Norris, Keith C ^f   Kovesdy, Csaba P ^g,h   Kopple, Joel D ⁱ   Kalantar Zadeh, Kamyar ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c SEMMELWEIS UNIVERSITY   (Hungary)

^d UNIVERSITY HEALTH NETWORK   (Canada)

^e DAVITA INC   (United States)

^f UNIVERSITY OF CALIFORNIA   (United States)

^g VETERANS AFFAIRS MEDICAL CENTER   (United States)

^h UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER   (United States)

ⁱ HARBOR UCLA MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

NITROGEN; PROTEIN;

ADULT; AGED; ANOREXIA; ARTICLE; CAUCASIAN; CAUSE OF DEATH; CHRONIC KIDNEY DISEASE; COHORT ANALYSIS; FEMALE; HEMODIALYSIS PATIENT; HISPANIC; HUMAN; HYPOALBUMINEMIA; INFLAMMATION; MAINTENANCE THERAPY; MAJOR CLINICAL STUDY; MALE; MORTALITY; NEGRO; PROSPECTIVE STUDY; PROTEIN CALORIE MALNUTRITION; PROTEIN DEGRADATION; PROTEIN INTAKE; RISK ASSESSMENT;

AGED; AGED, 80 AND OVER; BIOLOGICAL MARKERS; DIET, PROTEIN-RESTRICTED; DIETARY PROTEINS; FEMALE; FOLLOW-UP STUDIES; HUMANS; INFLAMMATION; MALE; MIDDLE AGED; NITROGEN; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; RENAL DIALYSIS; RENAL INSUFFICIENCY, CHRONIC; RISK FACTORS;

EID: 84879804359     PISSN: 00223166     EISSN: 15416100     Source Type: Journal    
DOI: 10.3945/jn.112.169722     Document Type: Article

References (49)

1. Shinaberger CS, Kilpatrick RD, Regidor DL, McAllister CJ, Greenland S, Kopple JD, Kalantar-Zadeh K. Longitudinal associations between dietary protein intake and survival in hemodialysis patients. Am J Kidney Dis. 2006;48:37-49.
2. Kopple JD. The National Kidney Foundation K/DOQI clinical practice guidelines for dietary protein intake for chronic dialysis patients. Am J Kidney Dis. 2001;38:S68-73.
3. Kalantar-Zadeh K, Block G, McAllister CJ, Humphreys MH, Kopple JD. Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. Am J Clin Nutr. 2004;80:299-307.
4. Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis. 2003;42:864-81.
5. Kalantar-Zadeh K, Cano NJ, Budde K, Chazot C, Kovesdy CP, Mak RH,Mehrotra R, Raj DS, Sehgal AR, Stenvinkel P, et al. Diets and enteral supplements for improving outcomes in chronic kidney disease. Nat Rev Nephrol. 2011;7:369-84.
6. Ling PR, Smith RJ, Kie S, Boyce P, Bistrian BR. Effects of protein malnutrition on IL-6-mediated signaling in the liver and the systemic acute-phase response in rats. Am J Physiol Regul Integr Comp Physiol. 2004;287:R801-8.
7. Mehrotra R, Duong U, Jiwakanon S, Kovesdy CP, Moran J, Kopple JD, Kalantar-Zadeh K. Serum albumin as a predictor of mortality in peritoneal dialysis: comparisons with hemodialysis. Am J Kidney Dis. 2011;58:418-28.
8. Kalantar-Zadeh K, Kilpatrick RD, Kuwae N, McAllister CJ, Alcorn H Jr, Kopple JD, Greenland S. Revisiting mortality predictability of serum albumin in the dialysis population: time dependency, longitudinal changes and population-attributable fraction. Nephrol Dial Transplant. 2005;20:1880-9.
9. Molnar MZ, Kovesdy CP, Bunnapradist S, Streja E, Mehrotra R, Krishnan M, Nissenson AR, Kalantar-Zadeh K. Associations of pretransplant serum albumin with post-transplant outcomes in kidney transplant recipients. Am J Transplant. 2011;11:1006-15.
10. Dezfuli A, Scholl D, Lindenfeld SM, Kovesdy CP, Kalantar-Zadeh K. Severity of hypoalbuminemia predicts response to intradialytic parenteral nutrition in hemodialysis patients. J Ren Nutr. 2009;19:291-7.
11. Cano N, Labastie-Coeyrehourq J, Lacombe P, Stroumza P, di Costanzo- Dufetel J, Durbec JP, Coudray-Lucas C, Cynober L. Perdialytic parenteral nutrition with lipids and amino acids in malnourished hemodialysis patients. Am J Clin Nutr. 1990;52:726-30.
12. Cano NJ, Fouque D, Roth H, Aparicio M, Azar R, Canaud B, Chauveau P, Combe C, Laville M, Leverve XM, et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J Am Soc Nephrol. 2007;18: 2583-91.
13. Kopple JD, Cheung AK, Christiansen JS, Djurhuus CB, El Nahas M, Feldt-Rasmussen B, Mitch WE, Wanner C, Gothberg M, Ikizler TA. Opportunity & trade: a large-scale randomized clinical trial of growth hormone in hemodialysis patients. Nephrol Dial Transplant. 2011;26: 4095-103.
14. Wolfson M, Jones MR, Kopple JD. Amino acid losses during hemodialysis with infusion of amino acids and glucose. Kidney Int. 1982;21: 500-6.
15. Streja E, Kovesdy CP, Molnar MZ, Norris KC, Greenland S, Nissenson AR, Kopple JD, Kalantar-Zadeh K. Role of nutritional status and inflammation in higher survival of African American and Hispanic hemodialysis patients. Am J Kidney Dis. 2011;57:883-93.
16. Ricks J, Molnar MZ, Kovesdy CP, Kopple JD, Norris KC, Mehrotra R, Nissenson AR, Arah OA, Greenland S, Kalantar-Zadeh K. Racial and ethnic differences in the association of body mass index and survival in maintenance hemodialysis patients. Am J Kidney Dis. 2011;58:574-82.
17. Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, Greenland S, Kopple JD. Reverse epidemiology of hypertension and cardiovascular death in the hemodialysis population: the 58th annual fall conference and scientific sessions. Hypertension. 2005;45:811-7.
18. Longenecker JC, Coresh J, Klag MJ, Levey AS, Martin AA, Fink NE, Powe NR. Validation of comorbid conditions on the end-stage renal disease medical evidence report: the CHOICE study. Choices for Healthy Outcomes in Caring for ESRD. J Am Soc Nephrol. 2000;11:520-9.
19. Molnar MZ, Streja E, Kovesdy CP, Budoff MJ, Nissenson AR, Krishnan M, Anker SD, Norris KC, Fonarow GC, Kalantar-Zadeh K. High platelet count as a link between renal cachexia and cardiovascular mortality in end-stage renal disease patients. Am J Clin Nutr. 2011;94:945-54.
20. Molnar MZ, Lukowsky LR, Streja E, Dukkipati R, Jing J, Nissenson AR, Kovesdy CP, Kalantar-Zadeh K. Blood pressure and survival in long-term hemodialysis patients with and without polycystic kidney disease. J Hypertens. 2010;28:2475-84.
21. Miller JE, Kovesdy CP, Nissenson AR,Mehrotra R, Streja E, VanWyck D, Greenland S, Kalantar-Zadeh K. Association of hemodialysis treatment time and dose with mortality and the role of race and sex. Am J Kidney Dis. 2010;55:100-12.
22. Miller JE, Kovesdy CP, Norris KC, Mehrotra R, Nissenson AR, Kopple JD, Kalantar-Zadeh K. Association of cumulatively low or high serum calcium levels with mortality in long-term hemodialysis patients. Am J Nephrol. 2010;32:403-13.
23. Kalantar-Zadeh K, Streja E, Kovesdy CP, Oreopoulos A, Noori N, Jing J, Nissenson AR, Krishnan M, Kopple JD, Mehrotra R, et al. The obesity paradox and mortality associated with surrogates of body size and muscle mass in patients receiving hemodialysis. Mayo Clin Proc. 2010;85:991-1001.
24. Kalantar-Zadeh K, Miller JE, Kovesdy CP, Mehrotra R, Lukowsky LR, Streja E, Ricks J, Jing J, Nissenson AR, Greenland S, et al. Impact of race on hyperparathyroidism, mineral disarrays, administered vitamin D mimetic, and survival in hemodialysis patients. J Bone Miner Res. 2010;25:2724-34.
25. Daugirdas JT. The post:pre dialysis plasma urea nitrogen ratio to estimate K.t/V and NPCR: validation. Int J Artif Organs. 1989;12:420-7.
26. Kalantar-Zadeh K, Supasyndh O, Lehn RS, McAllister CJ, Kopple JD. Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt/V greater than 1.20. J Ren Nutr. 2003;13:15-25.
27. U.S. Renal Data System. USRDS 2011 annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011 [cited 12 Jan 2012]. Available from: http://www.usrds.org/adr.aspx.
28. Fellström BC, Jardine AG, Schmieder RE, Holdaas H, Bannister K, Beutler J, Chae DW, Chevaile A, Cobbe SM, Grö nhagen-Riska C, et al. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009;360:1395-407.
29. Wanner C, Krane V, Marz W, Olschewski M, Mann JF, Ruf G, Ritz E; German Diabetes and Dialysis Study Investigators. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005;353:238-48.
30. Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, Wanner C, Krane V, Cass A, Craig J, et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011;377:2181-92.
31. Wrone EM, Hornberger JM, Zehnder JL, McCann LM, Coplon NS, Fortmann SP. Randomized trial of folic acid for prevention of cardiovascular events in end-stage renal disease. J Am Soc Nephrol. 2004;15:420-6.
32. Cheung AK, Levin NW, Greene T, Agodoa L, Bailey J, Beck G, ClarkW, Levey AS, Leypoldt JK, Ornt DB, et al. Effects of high-flux hemodialysis on clinical outcomes: results of the HEMO study. J Am Soc Nephrol. 2003;14:3251-63.
33. Eknoyan G, Beck GJ, Cheung AK, Daugirdas JT, Greene T, Kusek JW, Allon M, Bailey J, Delmez JA, Depner TA, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med. 2002;347:2010-9.
34. Paniagua R, Amato D, Vonesh E, Correa-Rotter R, Ramos A, Moran J, Mujais S; Mexican Nephrology Collaborative Study Group. Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol. 2002;13:1307-20.
35. Leistikow B. Commentary: questionable premises, overadjustment, and a smoking/suicide association in younger adult men. Int J Epidemiol. 2003;32:1005-6.
36. Thompson WD. Overadjustment in case-control studies. Am J Epidemiol. 1982;115:797-801.
37. Canaud B, Leblanc M, Garred LJ, Bosc JY, Argiles A, Mion C. Protein catabolic rate over lean body mass ratio: a more rational approach to normalize the protein catabolic rate in dialysis patients. Am J Kidney Dis. 1997;30:672-9.
38. Harty JC, Boulton H, Curwell J, Heelis N, Uttley L, Venning MC, Gokal R. The normalized protein catabolic rate is a flawed marker of nutrition in CAPD patients. Kidney Int. 1994;45:103-9.
39. Kalantar-Zadeh K, Kovesdy CP, Bross R, Benner D, Noori N, Murali SB, Block T, Norris J, Kopple JD, Block G. Design and development of a dialysis food frequency questionnaire. J Ren Nutr. 2011;21:257-62.
40. Bross R, Noori N, Kovesdy CP, Murali SB, Benner D, Block G, Kopple JD, Kalantar-Zadeh K. Dietary assessment of individuals with chronic kidney disease. Semin Dial. 2010;23:359-64.
41. Noori N, Kovesdy CP, Dukkipati R, Feroze U, Molnar MZ, Bross R, Nissenson AR, Kopple JD, Norris KC, Kalantar-Zadeh K. Racial and ethnic differences in mortality of hemodialysis patients: role of dietary and nutritional status and inflammation. Am J Nephrol. 2011;33:157-67.
42. Reddan DN, Klassen PS, Szczech LA, Coladonato JA, O'Shea S, Owen WF Jr, Lowrie EG. White blood cells as a novel mortality predictor in haemodialysis patients. Nephrol Dial Transplant. 2003;18: 1167-73.
43. Kalantar-Zadeh K, Don BR, Rodriguez RA, Humphreys MH. Serum ferritin is a marker of morbidity and mortality in hemodialysis patients. Am J Kidney Dis. 2001;37:564-72.
44. Kalantar-Zadeh K, Kleiner M, Dunne E, Ahern K, Nelson M, Koslowe R, Luft FC. Total iron-binding capacity-estimated transferrin correlates with the nutritional subjective global assessment in hemodialysis patients. Am J Kidney Dis. 1998;31:263-72.
45. Kalantar-Zadeh K, Rodriguez RA, Humphreys MH. Association between serum ferritin and measures of inflammation, nutrition and iron in haemodialysis patients. Nephrol Dial Transplant. 2004;19:141- 9.
46. Kalender B, Mutlu B, ErsozM, Kalkan A, Yilmaz A. The effects of acute phase proteins on serum albumin, transferrin and haemoglobin in haemodialysis patients. Int J Clin Pract. 2002;56:505-8.
47. Kopple JD, Gao XL, Qing DP. Dietary protein, urea nitrogen appearance and total nitrogen appearance in chronic renal failure and CAPD patients. Kidney Int. 1997;52:486-94.
48. Kalantar-Zadeh K, Braglia A, Chow J, Kwon O, Kuwae N, Colman S, Cockram DB, Kopple JD. An anti-inflammatory and antioxidant nutritional supplement for hypoalbuminemic hemodialysis patients: a pilot/feasibility study. J Ren Nutr. 2005;15:318-31.
49. Rammohan M, Kalantar-Zadeh K, Liang A, Ghossein C. Megestrol acetate in a moderate dose for the treatment of malnutritioninflammation complex in maintenance dialysis patients. J Ren Nutr. 2005;15:345-5.5