Abstract
Background: Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. Objectives: In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. Methods: In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. Results: Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2. Conclusion: The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.
Highlights
In this single-center, prospective cohort study conducted in Japan, protein-energy wasting (PEW) score was calculated for 180 maintenance hemodialysis patients (MHD) patients
We previously proposed a new and simple PEW score that appears to be useful for assessing the risk of mortality in patients on MHD [5]
We aimed to demonstrate the usefulness of this simple PEW score as a predictor of hospitalization in MHD patients
Summary
The proposed approach lacks versatility because it is difficult to assess the reduced muscle mass To address this issue, a new and simplified scoring method using serum creatinine adjusted for body surface area (SCr/BSA) was proposed in 2014 [4]. We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. Objectives: In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. Conclusion: The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is useful for identifying subgroups of MHD patients with a high risk of mortality
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