Severity of protein-energy wasting and obesity are independently related with poor quality of life in peritoneal dialysis patients |
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Institution: | 1. Unidad de Investigación Biomédica 02, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Mexico;2. Universidad Internacional Iberoamericana, Campeche, Mexico;3. Dirección de Enfermería, Hospital de Especialidades, IMSS, Guadalajara, Mexico;4. Unidad de Investigación en Enfermedades Nefrológicas, Hospital de Especialidades, CMN Siglo XXI, IMSS, Ciudad de México, Mexico |
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Abstract: | Protein-energy wasting (PEW) and poor health-related quality of life (HRQoL) are independently associated with morbi-mortality in continuous ambulatory peritoneal dialysis (CAPD). PEW may reduce HRQoL; however, we hypothesized HRQoL is affected differentially by PEW degrees or by individual criteria of nutritional status.AimTo evaluate HRQoL according to PEW severity and nutritional status indicators in CAPD.This is a cross-sectional study in 151 patients. Subjective global assessment (SGA) was employed, and nutritional status classified as normal, mild-moderate PEW, and severe PEW. HRQoL was evaluated using Kidney Disease Quality of Life Short Form?, including physical (PCS), mental (MCS) and kidney disease (KDCS) components, and their subscales. Dietary intake, anthropometric and biochemical variables were measured.Forty-six percent of patients were well-nourished, 44% had mild-moderate PEW, and 10% severe PEW. Compared with well-nourished patients, those with mild-moderate (p = 0.06) and severe (p = 0.005) PEW had lower HRQoL score 68 (52–75), 55 (45–72), 46 (43–58), respectively]. PCS, MCS, and KDCS and their subscales had lower values as PEW was more severe. Patients with obesity and hypoalbuminemia had significantly lower HRQoL overall and component scores than their counterparts. Dietary intake was not associated with quality of life. In multivariate analysis obesity, PEW (by SGA), hypoalbuminemia, and low educational level predicted poor HRQoL (χ2 58.2, p < 0.0001).As conclusion, PEW severity was related with worse HRQoL, either as overall score or in every component or subscale in CAPD patients. Poor HRQoL was predicted independently by PEW severity and obesity; additional predictors were hypoalbuminemia and low education. |
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Keywords: | Protein-energy wasting Malnutrition Obesity Quality of life Peritoneal dialysis Desgaste proteico-energético Desnutrición Obesidad Calidad de vida Diálisis peritoneal |
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