P0931PROTEIN ENERGY WASTING ON MORTALITY IN HEMODIALYSIS PATIENTS IN DIFFERENT SERUM ALBUMIN AND CHOLESTEROL LEVELS: A POPULATION STUDY IN TAIWAN

Abstract

Abstract Background and Aims Protein-energy wasting, hypoalbuminemia and hypercholesterolemia play an important role in mortality among hemodialysis (HD) patients. How hypoalbuminemia and hypercholesterolemia influence the nutrition (normalized protein catabolic rate (nPCR)) related mortality among HD patients is still unclear. Method Using the nationwide data from the Taiwan Renal Registry Data System (TWRDS) between 2005 and 2012, we divided the HD patients into nPCR<1.2 and nPCR≥1.2 groups. The relation of nPCR with three-year all-cause and cardiovascular mortality were determined. The influence of serum albumin (Alb) and cholesterol (TC) on nPCR related mortality were further analysed. Results Of 88,330 HD patients, 58122 (85.6%) patients were among nPCR <1.2 group and 30,208 (14.4%) in nPCR≥1.2 group. Both all-cause and cardiovascular mortality were increased in nPCR <1.2 group. In the nPCR <1.2 subjects, Alb ≥ 3.7 was associated with increased risk of both overall and CV mortality (adjusted hazard ratio [HR]; 95% confidence interval [CI]: 1.16; 1.07–1.25, p=0.0003 and 1.15; 1.02–1.13, p=0.03) compared to the those with Alb < 3.7 (adjusted hazard ratio [HR]; 95% confidence interval [CI]: 1.00; 0.90–1.08, p=0.74 and 1.15; 1.02–1.31, p=0.03). Further analysis revealed that in nPCR < 1.2 and Alb ≥ 3.7 group, TC ≥ 150 had increased risk of both all-cause and CV mortalities (adjusted hazard ratio [HR]; 95% confidence interval [CI]: 1.14; 1.04–1.25, p=0.005 and 1.17; 1.02–1.35, p=0.026). No significant relation was found betweent mortality and nPCR among patients with Alb < 3.7 irrespective of TC levels. Conclusion From this nationwide study, we found the close relation between dietary protein intake and mortality among those with Alb ≥ 3.7 and TC ≥ 150 group. Thus, we need to emphasize the importance of cholesterol control and dietary protein intake even among HD patients with normal serum albumin levels.