TY - JOUR
T1 - Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: a longitudinal (pilot) study
AU - McKeaveney, Clare
AU - Slee, Adrian
AU - Davenport, Andrew
AU - Adamson, Gary
AU - Farrington, Ken
AU - Fouque, Denis
AU - Kalantar-Zadeh, Kamyar
AU - Mallett, John
AU - Maxwell, Peter
AU - Mullan, Robert
AU - Noble, Helen
AU - O'Donoghue, Donal
AU - Porter, Sam
AU - Seres, David S.
AU - Shields, Joanne
AU - Witham, Miles
AU - Reid, Joanne
PY - 2020/11/5
Y1 - 2020/11/5
N2 - BackgroundResearch indicates that cachexia is common among persons with chronic illnesses and is associated with increased morbidity and mortality. However, there continues to be an absence of a uniformed disease specific definition for cachexia in chronic kidney disease (CKD) patient populations. ObjectiveThe primary objective was to identify cachexia in patients receiving haemodialysis (HD) using Evans et al. generic definition, and then follow up on these patients over 12 months.MethodThis was a longitudinal of 106 adult chronic haemodialysis patients attending two hospital HD units in the United Kingdom. Multiple measures relevant to cachexia including body mass index (BMI), muscle mass (Mid Upper Arm Muscle Circumference; MUAMC), handgrip strength (HGS), fatigue (Functional Assessment of Chronic Illness Therapy; FACIT), appetite (Functional Assessment of Anorexia/Cachexia Therapy; FAACT) and biomarkers (C-reactive protein (CRP); serum albumin; haemoglobin, and Erythropoietin Resistance Index (ERI)) were recorded. Baseline analysis included group differences analysed using independent t-test, dichotomized values using the X2 test and prevalence were reported using SPSS 24. Longitudinal analysis was conducted using repeated measures analysis. ResultsOne hundred and six patients (30 female and 76 male) were recruited with a mean age of 67.6 years (SD=13.18) and dialysis vintage of 4.92 years (SD=6.12). At baseline, 17 patients were identified as cachectic, having had reported weight loss (e.g. >5% over 6 months) or BMI (<20 kg/m2) and three or more clinical characteristics of cachexia (7). Seventy patients were available for analysis after 12 months (n=11 cachectic vs. n=59 not cachectic). FAACT and URR statistically distinguished cachectic patients (p=.001). However, measures of weight, BMI, MUAMC, HGS, CRP, ERI and FACIT tended to be worse in cachectic patients. ConclusionGlobally, cachexia is a serious but frequently under-recognised problem. This is the first study to apply the defined characteristics of cachexia to a representative sample of patients receiving HD. Further larger studies are required to establish a phenotype of cachexia in advanced CKD.
AB - BackgroundResearch indicates that cachexia is common among persons with chronic illnesses and is associated with increased morbidity and mortality. However, there continues to be an absence of a uniformed disease specific definition for cachexia in chronic kidney disease (CKD) patient populations. ObjectiveThe primary objective was to identify cachexia in patients receiving haemodialysis (HD) using Evans et al. generic definition, and then follow up on these patients over 12 months.MethodThis was a longitudinal of 106 adult chronic haemodialysis patients attending two hospital HD units in the United Kingdom. Multiple measures relevant to cachexia including body mass index (BMI), muscle mass (Mid Upper Arm Muscle Circumference; MUAMC), handgrip strength (HGS), fatigue (Functional Assessment of Chronic Illness Therapy; FACIT), appetite (Functional Assessment of Anorexia/Cachexia Therapy; FAACT) and biomarkers (C-reactive protein (CRP); serum albumin; haemoglobin, and Erythropoietin Resistance Index (ERI)) were recorded. Baseline analysis included group differences analysed using independent t-test, dichotomized values using the X2 test and prevalence were reported using SPSS 24. Longitudinal analysis was conducted using repeated measures analysis. ResultsOne hundred and six patients (30 female and 76 male) were recruited with a mean age of 67.6 years (SD=13.18) and dialysis vintage of 4.92 years (SD=6.12). At baseline, 17 patients were identified as cachectic, having had reported weight loss (e.g. >5% over 6 months) or BMI (<20 kg/m2) and three or more clinical characteristics of cachexia (7). Seventy patients were available for analysis after 12 months (n=11 cachectic vs. n=59 not cachectic). FAACT and URR statistically distinguished cachectic patients (p=.001). However, measures of weight, BMI, MUAMC, HGS, CRP, ERI and FACIT tended to be worse in cachectic patients. ConclusionGlobally, cachexia is a serious but frequently under-recognised problem. This is the first study to apply the defined characteristics of cachexia to a representative sample of patients receiving HD. Further larger studies are required to establish a phenotype of cachexia in advanced CKD.
KW - Haemodialysis
KW - Cachexia
KW - Phenotype
KW - Definition
KW - Longitudinal analysis
U2 - 10.1093/ndt/gfaa174
DO - 10.1093/ndt/gfaa174
M3 - Article
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
ER -