McKeaveney, C;
Slee, A;
Adamson, G;
Davenport, A;
Farrington, K;
Fouque, D;
Kalantar-Zadeh, K;
... Reid, J; + view all
(2021)
Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: a longitudinal (pilot) study.
Nephrology Dialysis Transplantation
, 36
(10)
pp. 1919-1926.
10.1093/ndt/gfaa174.
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Abstract
Background: Research 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. Objective: The primary objective was to identify cachexia in patients receiving haemodialysis (HD) using a generic definition and then follow up on these patients for 12 months. Method: This was a longitudinal study of adult chronic HD patients attending two hospital HD units in the UK. 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 an independent t-test, dichotomized values using the χ2 test and prevalence were reported using the Statistical Package for the Social Sciences 24 (IBM, Armonk, NY, USA). Longitudinal analysis was conducted using repeated measures analysis. Results: A total of 106 patients (30 females and 76 males) were recruited with a mean age of 67.6 years [standard deviation (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% for >6 months) or BMI <20 kg/m2 and three or more clinical characteristics of cachexia. Seventy patients were available for analysis at 12 months (11 cachectic versus 59 not cachectic). FAACT and urea reduction ratio statistically distinguished cachectic patients (P = 0.001). However, measures of weight, BMI, MUAMC, HGS, CRP, ERI and FACIT tended to worsen in cachectic patients. Conclusion: Globally, cachexia is a severe but frequently underrecognized problem. This is the first study to apply the defined characteristics of cachexia to a representative sample of patients receiving HD. Further, more extensive studies are required to establish a phenotype of cachexia in advanced CKD.
| Type: | Article |
|---|---|
| Title: | Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: a longitudinal (pilot) study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ndt/gfaa174 |
| Publisher version: | https://doi.org/10.1093/ndt/gfaa174 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | cachexia, definition, haemodialysis, longitudinal analysis, phenotype, STAGE RENAL-DISEASE, FUNCTIONAL ASSESSMENT, CANCER, FATIGUE, PREVALENCE, UPDATE, MORTALITY, CONSENSUS, SLEEP |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Education |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10138990 |
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