Body composition and cardiovascular risk factors in pretransplant hemodialysis patients

被引:14
作者
Guida, B
Trio, R
Nastasi, A
Laccetti, R
Pesola, D
Torraca, S
Memoli, B
Cianciaruso, B
机构
[1] Univ Naples, Dept Neurosci, Physiol Nutr Sect, I-80131 Naples, Italy
[2] Univ Naples, Dept Nephrol, I-80131 Naples, Italy
关键词
hemodialysis; obesity; bioelectrical impedance; analysis; cardiovascular risk factors;
D O I
10.1016/j.clnu.2003.08.007
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Obesity, hyperlipemia and cardiovascular complications contribute to a significant proportion of morbidity and mortality of renal transplant patients and have negative effects on renal survival. Aim of the present study was to evaluate the main abnormalities in body composition and the prevalence of some cardiovascular risk factors in a population of hemodialyzed (HD) patients awaiting renal transplantation. Methods: We studied 151 HD patients, all included in a waiting list for renal transplantation, 97 mates and 54 females, with mean age 47.4+/-12 years. Patients were divided into three groups according to their body mass index (BMI) (kg/m(2)): 18.5 to 24.9 (normoweight, NW); 25.0 to 29.9 (overweight, OW); greater than or equal to30 (obese, OB). The body composition measurements were obtained the day after the mid-week HD session using bioelectrical impedance analysis (BIA). Results: We found that 47 patients were NW (31%), white 56 were OW (37%), and 48 were OB (32%). BIA-measured body cell mass was (BCM) significantly increased in the OW as compared with the NW group (P<0.001), but, of note, no significant difference was found in OB group in comparison with the OW. Total cholesterol and triglycerides ptasma levels were significantly elevated in OW and OB patients with respect to NW (P<0.05) and an increased prevalence of diabetes was seen in OB patients (NW: 6%, OW: 5%, OB: 12%). Conclusions: These data show that a large proportion of patients awaiting renal transplant are overweight or obese and a consistent part of them have other cardiovascular risk factors associated. Furthermore, obese HD patients have a BCM lower than predicted on the basis of BMI and show an altered metabolic profile. A better understanding of the characteristics of patients included in the renal transplant waiting list is crucial in order to design prospective studies that aim to define the proper risk profile for the selection of patients. (C) 2003 Elsevier Ltd. All rights reserved.
引用
收藏
页码:363 / 372
页数:10
相关论文
共 61 条
[1]   Impact of hemodialysis on dual X-ray absorptiometry, bioelectrical impedance measurements, and anthropometry [J].
Abrahamsen, B ;
Hansen, TB ;
Hogsberg, IM ;
Pedersen, FB ;
BeckNielsen, H .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1996, 63 (01) :80-86
[2]  
Bergström J, 2000, SEMIN DIALYSIS, V13, P163, DOI 10.1046/j.1525-139x.2000.00044.x
[3]   Malnutrition, cardiac disease, and mortality:: An integrated point of view [J].
Bergström, J ;
Lindholm, B .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1998, 32 (05) :834-841
[4]   Re-evaluation of risks associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: Recommendations for a change in management [J].
Block, GA ;
Port, FK .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2000, 35 (06) :1226-1237
[5]   Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients [J].
Bologa, RM ;
Levine, DM ;
Parker, TS ;
Cheigh, JS ;
Serur, D ;
Stenzel, KH ;
Rubin, AL .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1998, 32 (01) :107-114
[6]   SURVIVAL AS AN INDEX OF ADEQUACY OF DIALYSIS [J].
CHARRA, B ;
CALEMARD, E ;
RUFFET, M ;
CHAZOT, C ;
TERRAT, JC ;
VANEL, T ;
LAURENT, G .
KIDNEY INTERNATIONAL, 1992, 41 (05) :1286-1291
[7]  
CHERTOW GM, 1995, J AM SOC NEPHROL, V6, P75
[8]   Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients [J].
Cheung, AK ;
Sarnak, MJ ;
Yan, GF ;
Dwyer, JT ;
Heyka, RJ ;
Rocco, MV ;
Teehan, BP ;
Levey, AS .
KIDNEY INTERNATIONAL, 2000, 58 (01) :353-362
[9]  
Chung SH, 2000, PERITON DIALYSIS INT, V20, P19
[10]   CROSS-SECTIONAL COMPARISON OF MALNUTRITION IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS AND HEMODIALYSIS-PATIENTS [J].
CIANCIARUSO, B ;
BRUNORI, G ;
KOPPLE, JD ;
TRAVERSO, G ;
PANARELLO, G ;
ENIA, G ;
STRIPPOLI, P ;
DEVECCHI, A ;
QUERQUES, M ;
VIGLINO, G ;
VONESH, E ;
MAIORCA, R .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1995, 26 (03) :475-486