NDT Advance Access originally published online on July 6, 2004
Nephrology Dialysis Transplantation 2004 19(9):2181-2183; doi:10.1093/ndt/gfh296
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Nephrol Dial Transplant Vol. 19 No. 9 © ERA-EDTA 2004; all rights reserved
Personal Opinion
Wasting, but not malnutrition, predicts cardiovascular mortality in end-stage renal disease
Department of Renal Medicine and Baxter Novum, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden
Correspondence and offprint requests to: Peter Stenvinkel, MD, PhD, Division of Renal Medicine K56 St, Karolinska University Hospital, Huddinge, S-141 86 Stockholm, Sweden. Email: peter.stenvinkel@klinyet.ki.se
| The first 10% of the full text of this article appears below. |
Beddhu et al. [1] recently have reported that there were no positive associations of malnutrition with documented acute coronary syndromes requiring hospitalization in a large incident Medicare dialysis population. The authors state that their findings do not support our suggestion [2] of an association between malnutrition, inflammation and atherosclerosis (MIA hypothesis) in patients with end-stage renal disease (ESRD). No doubt the study by Beddhu et al. [1] is a well performed study conducted in a large group of dialysis patients. However, we feel that some fundamental issues regarding the nomenclature and definition of malnutrition need to be discussed. First, as discussed by Mitch [3], the use of the word malnutrition has often been used incorrectly in the renal literature, and, according to Mitch, malnutrition should be used to describe a deficient nutritional status caused by insufficient nutritient intake. However,
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