Abstract
Background: U.S. military veterans have high rates of chronic disease and social disadvantage, which are risk factors for protein-energy wasting (PEW). It is not known whether this translates into high prevalence of PEW in veterans with end-stage renal disease. Methods: We compared the clinical, socioeconomic, and nutrition status and the diet of 33 veteran and 38 nonveteran clinically stable patients receiving maintenance hemodialysis (MHD) in south-central Texas. Results: The whole cohort included 82% Mexican Americans (MAs), 72% type 2 diabetics, and 73% males. The body mass index was 28.9 ± 6.2, while energy intake was 21.5 ± 8.2 kcal/kg/d and protein intake was 1.0 ± 0.4 g/kg/d. Serum albumin (bromocresol purple) was 3.5 ± 0.4 g/dL, transferrin was 171.9 ± 27.8 mg/d, C-reactive protein was 2.9 (1.4-6.5) mg/L, interleukin-6 (IL-6) was 8.3 (4.2-17.9) pg/mL, neutrophil gelatinase-associated lipocalin was 729 (552-1256) ng/mL, and the malnutrition-inflammation score was 8.8 ± 3.0. In group comparison that adjusted for sex and ethnicity, the veterans had better household income, less MAs (60% vs 100%), more males (94% vs 55%), more use of a renin-angiotensin-aldosterone system blockade (66% vs 33%), and lower IL-6 levels (4.4 [3.1-5.8] vs 15.4 [8.3-20.5] pg/mL; P =.01) than nonveterans. In regression analysis, the lower serum IL-6 level in veterans was independently explained by dialysis clinic, sex, and, possibly, household income (intermediate significance). Conclusion: In a relatively small cohort of clinically stable MHD patients, the veterans showed equivalent nutrition status and dietary intake and less inflammation than the nonveterans, thus not supporting the possibility that veteran MHD patients may have worse nutrition than the nonveteran counterpart.
Original language | English |
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Pages (from-to) | 698-708 |
Number of pages | 11 |
Journal | Nutrition in Clinical Practice |
Volume | 30 |
Issue number | 5 |
DOIs | |
State | Published - 8 Oct 2015 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2015 American Society for Parenteral and Enteral Nutrition.
Funding
This work was supported by grants to PF from NIH-NCCAM (AT004490) and from the Veterans Administration (Merit Review 1I01CX000264) and by the CTSA program award to UTHSCSA (NIH-NCATS 1UL TR001120).
Funders | Funder number |
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NIH-NCATS | 1UL TR001120 |
NIH-NCCAM | AT004490 |
National Institutes of Health | R21AT004490 |
U.S. Department of Veterans Affairs | 1I01CX000264 |
National Center for Advancing Translational Sciences | UL1TR001120 |
University of Texas Health Science Center at San Antonio |
Keywords
- diabetes mellitus
- ethnic groups
- healthcare disparities
- inflammation
- socioeconomic factors
- wasting syndrome