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Published on: September 20, 2019
Influence of infection control for COVID-19 on nutrition in relatively healthy Japanese HD patients: a retrospective
Yuki Chiba1, Ryotaro Takahashi2, Rui Makino1
1Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Background:
Infection control for the novel coronavirus disease 2019 (COVID-19) has been linked to decreased physical activity and nutritional deterioration in the general population; however, the influence on hemodialysis (HD) patients is not well discussed.
Methods:
This multicenter retrospective study utilized the Geriatric Nutritional Risk Index (GNRI), Survival Index, and Nutritional Risk Index for Japanese HD patients (NRI-JH) to assess nutritional status and body composition over five observation periods. The primary endpoint was the body fluid removal rate (%) pre- and post-HD, whereas secondary endpoints included changes in GNRI, SI, body composition, and differences in NRI-JH.
Results:
We enrolled 139 HD patients in three facilities. The results showed a decrease in GNRI score, which indicates nutritional deterioration, between February 2020 and August 2020 (96.8 (93.2-98.9) vs. 93.8 (90.8-97.6)) (P = 0.0005). Multivariable analysis revealed that nutritional deterioration was associated with higher C-reactive protein and lower hemoglobin levels (P = 0.0004 and P = 0.0010, respectively), which were more noticeable in the urban facility. Furthermore, nutritional deterioration was linked to a decrease in soft lean and somatic cell mass and an increase in body fat mass, suggesting reduced physical activity.
Conclusions:
Nutritional deterioration was observed shortly after the first COVID-19 outbreak, suggesting an association with decreased physical activity.
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