de Araujo et al identified a number of factors affecting mortality in patients starting hemodialysis. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Federal University of Sao Paulo in Brazil.
Patient selection: patient just starting hemodialysis
Parameters:
(1) age in years
(2) diabetes mellitus
(3) serum albumin in g/dL
(4) mid-arm muscle circumference (MAMC) as percent of normal
(5) protein intake in g per kg per day
(6) energy intake in kcal per kg per day
(7) body mass index (BMI) in kg per square meter
|
Parameter |
Finding |
Points |
|
age of the patient |
<= 60 years of age |
0 |
|
|
> 60 years of age |
1 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
serum albumin |
>= 3.5 g/dL |
0 |
|
|
< 3.5 g/dL |
1 |
|
MAMC |
>= 90% of normal |
0 |
|
|
< 90% of normal |
1 |
|
protein intake |
>= 1.0 g per kg per day |
0 |
|
|
< 1 g per kg per day |
1 |
|
energy intake |
>= 25 kcal per kg per day |
0 |
|
|
< 25 kcal per kg per day |
1 |
number of risk factors for a worse survival =
= SUM(points for all 6 parameters)
|
BMI |
MAMC |
6 Year Survival |
|
>= 25 kg per square meter |
>= 90% |
best (60%) |
|
< 25 kg per square meter |
NA |
intermediate (40%) |
|
>= 25 per square meter |
< 90% |
worst (0%) |
Purpose: To identify risk factors for worse survival in a patient starting hemodialysis based on the study of de Araujo et al.
Specialty: Nutrition, Critical Care
Objective: risk factors, diet
ICD-10: N17-N19, Z49, Z49.1, Z99.2,
