Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Associations Between Malnutrition, Low Muscle Mass, and NT-ProBNP Levels
3.3. Mortality Risk Associated with Malnutrition, Low Muscle Mass, and Elevated NT-ProBNP Levels
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Risk Marker | Score Value |
---|---|
Body mass index | |
<20 kg/m2 | 3 |
Serum albumin | |
<3.7 g/dL (Age < 65 years); <3.5 g/dL (Age ≥ 65 years) | 4 |
Serum creatinine | |
Women <9.7 mg/dL (Age < 65 years); <8.0 mg/dL (Age ≥ 65 years) Men <11.6 mg/dL (Age < 65 years); <9.7 mg/dL (Age ≥ 65 years) | 4 |
Serum total cholesterol | |
<130 mg/dL | 1 |
≥220 mg/dL | 2 |
Categorization based on the total score: 0–7 points: low risk, 8–10 points: moderate risk, 11 points or more: high risk |
Patient Characteristics | NRI-JH | p | ||
---|---|---|---|---|
Low Risk (n = 287) | Moderate Risk (n = 56) | High Risk (n = 25) | ||
Age, years | 67 (56–74) | 64.5 (59–75) | 76 (56–82) | 0.06 |
Age < 65, n (%) | 107 (37.3) | 28 (50.0) | 8 (32.0) | |
Age 65–74, n (%) | 120 (41.8) | 13 (23.2) | 3 (12.0) | <0.001 |
Age ≥ 75, n (%) | 60 (20.8) | 15 (26.8) | 14 (56.0) | |
Men, n (%) | 201 (70.0) | 42 (75.0) | 18 (72.0) | 0.75 |
Diabetes, n (%) | 129 (45.0) | 32 (57.1) | 7 (28.0) | 0.046 |
Body mass index, kg/m2 | 22.7 (20.2–25.6) | 22.1 (20.8–25.0) | 18.3 (17.0–19.3) | <0.001 |
Serum albumin, g/dL | 3.6 (3.5–3.8) | 3.4 (3.2–3.5) | 3.3 (3.1–3.4) | <0.001 |
Serum sodium, mEq/L | 139 (138–141) | 139 (137–141) | 138 (137–139) | 0.047 |
Serum potassium, mEq/L | 4.9 (4.4–5.4) | 4.7 (4.2–5.0) | 4.7 (4.2–5.2) | 0.028 |
Serum chloride, mEq/L | 103 (101–105) | 104 (102–106) | 103 (102–106) | 0.48 |
Serum calcium, mg/dL | 8.7 (8.3–9.0) | 8.6 (8.2–8.9) | 8.3 (8.0–8.7) | 0.011 |
Serum phosphorus, mg/dL | 5.6 (5.0–6.4) | 5.1 (4.4–5.7) | 5.4 (4.7–6.5) | <0.001 |
Triglyceride, mg/dL | 105 (75–154) | 91 (67–127) | 64 (51–87) | <0.001 |
Total cholesterol, mg/dL | 165 (143–193) | 152 (130–185) | 159 (130–191) | 0.040 |
LDL-C, mg/dL | 87 (71–107) | 77.5 (62–104) | 75 (61–102) | 0.049 |
HDL-C, mg/dL | 50 (39–60) | 45 (37–57) | 54 (42–70) | 0.11 |
Uric acid, mg/dL | 7.9 (7.1–8.6) | 6.9 (6.2–8.0) | 6.9 (6.5–8.0) | <0.001 |
Blood urea nitrogen, mg/dL | 60.8 (52.2–71.4) | 49.6 (43.9–56.8) | 48.9 (45.5–59.0) | <0.001 |
Serum creatinine, mg/dL | 10.7 (9.4–12.3) | 8.8 (7.7–9.8) | 8.6 (7.4–9.0) | <0.001 |
Intact PTH, pg/mL | 154 (102–223) | 157 (99–197) | 138 (79–188) | 0.41 |
β2MG, mg/L | 26.0 (23.4–29.2) | 27.0 (22.6–29.7) | 26.6 (25.4–34) | 0.27 |
C-reactive protein, mg/dL | 0.1 (0–0.3) | 0.1 (0.1–0.5) | 0.3 (0–0.6) | 0.19 |
Hemoglobin, g/dL | 11.3 (10.7–11.9) | 11.0 (10.5–11.5) | 10.6 (9.8–11.4) | 0.002 |
NT-proBNP, pg/mL | 3000 (1610–6610) | 5900 (3478–11,075) | 7650 (4045–32,450) | <0.001 |
Variables | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
HR | 95%CI | p | HR | 95%CI | p | |
Age | 1.06 | (1.04–1.09) | <0.001 | 1.05 | (1.02–1.08) | <0.001 |
Diabetes | 1.66 | (0.93–2.98) | 0.09 | 1.48 | (0.80–2.77) | 0.21 |
Men | 2.15 | (1.00–4.62) | 0.049 | 2.15 | (0.95–4.86) | 0.07 |
CRP ≥ 0.3 mg/dL | 1.33 | (0.71–2.50 | 0.37 | 0.74 | (0.38–1.45) | 0.38 |
Moderate to high risk by NRI-JH | 4.98 | (2.79–8.91) | <0.001 | 3.52 | (1.92–6.44) | <0.001 |
Low muscle mass | 3.25 | (1.81–5.82) | <0.001 | 2.63 | (1.42–4.86) | 0.002 |
Top-quartile NT-proBNP levels | 5.45 | (3.02–9.88) | <0.001 | 3.40 | (1.81–6.38) | <0.001 |
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Takahashi, S.; Tanaka, T.; Suzuki, Y.; Yoshida, N.; Hitaka, M.; Ishii, S.; Yamazaki, K.; Masai, M.; Yamada, Y.; Ohashi, Y. Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients. Nutrients 2025, 17, 1896. https://doi.org/10.3390/nu17111896
Takahashi S, Tanaka T, Suzuki Y, Yoshida N, Hitaka M, Ishii S, Yamazaki K, Masai M, Yamada Y, Ohashi Y. Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients. Nutrients. 2025; 17(11):1896. https://doi.org/10.3390/nu17111896
Chicago/Turabian StyleTakahashi, Sadamu, Tatsuki Tanaka, Yusuke Suzuki, Norihito Yoshida, Mai Hitaka, Shingo Ishii, Keisuke Yamazaki, Motoyuki Masai, Yosuke Yamada, and Yasushi Ohashi. 2025. "Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients" Nutrients 17, no. 11: 1896. https://doi.org/10.3390/nu17111896
APA StyleTakahashi, S., Tanaka, T., Suzuki, Y., Yoshida, N., Hitaka, M., Ishii, S., Yamazaki, K., Masai, M., Yamada, Y., & Ohashi, Y. (2025). Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients. Nutrients, 17(11), 1896. https://doi.org/10.3390/nu17111896