application) The 250,000 chronic dialysis patients in the US have an increased rate of malnutrition and inflammation, which are felt to be major risk factors for their high morbidity and mortality. The risk of cardiovascular death appears to be especially high among these individuals. To date, there is no uniform, practical tool for assessment of nutritional status, inflammation and food intake in dialysis patients. The goals of this prospective cohort study are to determine whether the nutritional and inflammatory states in dialysis population affect the mortality, morbidity, and other clinical outcomes in a predictable way and to ascertain how the deterioration of these indices over time is associated with poor outcome. To achieve these goals, we will study a cohort of dialysis patients in the San Francisco Bay Area prospectively. Nutritional assessment will be performed periodically. A convenient but reliable nutritional scoring system to predict the mortality and clinical outcome in the dialysis population will be developed and validated. The following specific questions will be answered: 1) Are the dialysis mortality and risk of cardiovascular death associated with malnutrition or inflammation? 2) Do malnutrition and/or inflammation and their deterioration over time have measurable, distinct impact on relevant clinical outcomes in dialysis patients such as hospitalization and erythropoietin resistance? 3) Can a numerical result of a uniform nutritional scoring system be a reliable predictor of dialysis morbidity and mortality? 4) Can a food questionnaire reliably detect deficient nutrient intake in dialysis patients? As a Mentored Patient-Oriented Research Career Development Award, this proposal also aims to develop the research abilities of the PI, and enables him to be a productive independent researcher.
Showing the most recent 10 out of 75 publications
