Gigante A, Rosato E, Barbano B, Di Mario F, Di Lazzaro-Giraldi G, Gasperini M L, Pofi R, Laviano A
Department of Clinical Medicine, Sapienza University, Rome, Italy.
Department of Experimental Medicine, Sapienza University, Rome, Italy.
J Biol Regul Homeost Agents. 2018 Jan-Feb;32(1):163-166.
Cardiorenal syndrome (CRS) describes the concurrent failure of cardiac and renal function, each influencing the other. Malnutrition and cachexia frequently develop in patients with heart failure or kidney failure. However, no information is currently available on the prevalence of malnutrition in CRS patients. We studied CRS patients admitted to an internal medicine ward during a 5-month period and evaluated their clinical characteristics and nutritional status. Malnutrition risk was assessed by using the validated screening tool NRS-2002 whilst body composition was assessed by bioimpedance analysis and muscle function was measured by handgrip (HG) strength. Cardiac mass was also recorded. Length of stay, hospital readmission and 6-month mortality were registered. During the study period, 22 CRS patients were studied. Twenty patients were diagnosed with either CRS type 1 or CRS type 5. In CRS patients, fat-free mass showed a trend toward representing a protective factor for 6-month mortality (OR=0.904; p=0.06). Also, fat-free mass correlated with HG strength and cardiac ejection fraction. Malnutrition risk was diagnosed in 45% of the patients, whereas 8 patients met the definition of cachexia. Even without statistical significance, CRS patients with malnutrition had lower BMI (Body Mass Index) (p=0.038) and fat-free mass (p= n.s.). However, CRS malnutrition was associated to higher 6-month mortality (p= 0.05), and appears to negatively influence the outcome in CRS (OR= 9; p= 0.06). Our results show that malnutrition is prevalent in CRS patients and influences the clinical outcome. The assessment of nutritional status, and particularly body composition, should be implemented in daily practice of patients with CRS.
心肾综合征（CRS）指心脏和肾脏功能同时衰竭，且二者相互影响。营养不良和恶病质在心力衰竭或肾衰竭患者中经常出现。然而，目前尚无关于CRS患者营养不良患病率的信息。我们研究了在内科病房住院5个月的CRS患者，并评估了他们的临床特征和营养状况。使用经过验证的筛查工具NRS-2002评估营养不良风险，通过生物电阻抗分析评估身体成分，通过握力（HG）测量肌肉功能。同时记录心脏质量。记录住院时间、再次入院情况和6个月死亡率。在研究期间，共研究了22例CRS患者。20例患者被诊断为1型或5型CRS。在CRS患者中，去脂体重显示出对6个月死亡率具有保护作用的趋势（OR=0.904；p=0.06）。此外，去脂体重与握力和心脏射血分数相关。45%的患者被诊断为有营养不良风险，而8例患者符合恶病质的定义。即使无统计学意义，患有营养不良的CRS患者的体重指数（BMI）较低（p=0.038），去脂体重也较低（p=无显著差异）。然而，CRS患者的营养不良与6个月较高的死亡率相关（p=0.05），并且似乎对CRS的预后有负面影响（OR=9；p=0.06）。我们的结果表明，营养不良在CRS患者中普遍存在，并影响临床预后。在CRS患者的日常诊疗中应进行营养状况评估，尤其是身体成分评估。
