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Publications (3)3.94 Total impact

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    ABSTRACT: Background: Malnutrition-Inflammation Score (MIS) has proved to predict the prospective mortality in maintenance hemodialysis (MHD) patients. However, its value of long-term mortality predictability in peritoneal dialysis (PD) patients has not been adequately studied. Methods: A total of 155 chronic stable PD patients from November 2005 to December 2006 were enrolled. At baseline, the MIS, Subjective Global Assessment (SGA), as well as clinical, laboratory, and anthropometric parameters were recorded. All patients were followed until October 2009 to evaluate mortality as a primary outcome. Results: The MIS correlated very well with SGA and other nutrition and inflammation markers. Patients with a higher MIS had a worse survival rate compared to those with lower MIS. After adjusting for potential confounding factors, one unit increase of MIS was associated with a 1.27-fold greater death risk (hazard ratio: 1.27, 95% confidence interval: 1.19 - 1.36; p < 0.001). MIS had a superior mortality predictability compared with SGA. Moreover, univariate and multivariate analyses denoted MIS, age, dialysis vintage, and comorbidities as independent predictors of total mortality. Conclusion: MIS is a promising marker for malnutrition inflammation assessment and an independent predictor of long-term mortality in Chinese PD patients.
    Clinical nephrology 02/2013; · 1.29 Impact Factor
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    ABSTRACT: BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is widely used as a marker of inflammation and an indicator of cardiovascular outcomes in patients with coronary artery disease. However, its prognostic value in peritoneal dialysis (PD) patients is still unknown. METHODS: We studied 138 newly started PD patients and 60 healthy controls at the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. Baseline NLR as well as demographic, clinical, and biochemical parameters were recorded. All patients were followed up until March 2011 to evaluate mortality as the primary outcome. Overall and cardiovascular disease-free survival rates were compared according to NLR level. Multivariate analysis was performed to assess the prognostic value of NLR. RESULTS: Baseline NLR levels (mean 3.5 ± 1.6) were significantly increased in PD patients compared to healthy controls (mean 1.5 ± 0.5; P < 0.001). Patients with higher NLR had a higher mortality rate compared with patients with lower NLR (51.5% vs 22.9%; P = 0.006). The 1-year and 3-year overall survival rates were 86.6% and 65.9% for patients with higher NLR compared with 97% and 85.1% for patients with lower NLR (P = 0.006). Patients with higher NLR also showed a higher cardiovascular mortality rate, compared with patients with lower NLR (38% vs 7.6%; P = 0.003). The 1-year and 3-year cardiovascular event-free survival rates were 90.7% and 81.9% for patients with higher NLR, compared with 98.6% and 95.1% for patients with lower NLR. Multivariate analysis showed high NLR value was an independent risk factor for all-cause and cardiovascular mortality. CONCLUSION: Neutrophil to lymphocyte ratio is a strong predictor for overall and cardiovascular mortality in PD patients.
    International Urology and Nephrology 01/2012; · 1.33 Impact Factor
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    ABSTRACT: Depression, the most common psychological disorder among patients with end-stage renal disease (ESRD), is associated with poor survival. The prevalence of depression and its relation with the malnutrition-inflammation complex syndrome (MICS) have not yet been clearly defined in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients. A total of 142 patients on CAPD were enrolled in the First Affiliated Hospital of Sun Yat-Sen University. The Hamilton Depression Scale (HAMD) and the malnutrition-inflammation score (MIS) were used for depression and MICS evaluation, respectively. Clinical, socioeconomic, and malnutrition-inflammation factors were compared among patients with and without depression. Binary regression analysis was performed to investigate the independent association between depression and MICS. The mean HAMD and MIS scores were 7.12 ± 5.28 and 4.45 ± 3.56, respectively. According to HAMD, 37 patients (26.1%) had depression and 70 patients (49.3%) had potential depression. Older age, longer dialysis vintage, worse residual renal function, lower employment and reimbursement status, and higher comorbidity index were positively correlated with depression. Compared to non-depressed patients, the depressed ones also showed lower levels of serum albumin and higher levels of C-reactive protein (CRP). Correlation results showed that the HAMD scores were significantly and positively correlated with MIS (r = 0.46, P < 0.01). Moreover, the incidence of peritonitis was significantly higher in depressed compared to non-depressed patients. Binary regression analysis showed that MIS was the only independent risk factor for depression. Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.
    International Urology and Nephrology 03/2011; 43(3):875-82. · 1.33 Impact Factor