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Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: A longitudinal (pilot) study.

McKeaveney, C., Slee, A., Adamson, G., Davenport, A., Farrington, K., Fouque, D., Kalantar-Zadeh, K., Mallett, J., Maxwell, A. P., Mullan, R., Noble, H., O'Donoghue, D., Porter, S., Seres, D. S., Shields, J., Witham, M. and Reid, J., 2020. Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: A longitudinal (pilot) study. Nephrology Dialysis Transplantation, 36 (10), 1919-1926.

Full text available as:

Pilot study NDT.pdf


DOI: 10.1093/ndt/gfaa174


Background: Research indicates that cachexia is common among persons with chronic illnesses and is associated with increased morbidity and mortality. However, there continues to be an absence of a uniformed disease-specific definition for cachexia in chronic kidney disease (CKD) patient populations. Objective: The primary objective was to identify cachexia in patients receiving haemodialysis (HD) using a generic definition and then follow up on these patients for 12 months. Method: This was a longitudinal study of adult chronic HD patients attending two hospital HD units in the UK. Multiple measures relevant to cachexia, including body mass index (BMI), muscle mass [mid-upper arm muscle circumference (MUAMC)], handgrip strength (HGS), fatigue [Functional Assessment of Chronic Illness Therapy (FACIT)], appetite [Functional Assessment of Anorexia/Cachexia Therapy (FAACT)] and biomarkers [C-reactive protein (CRP), serum albumin, haemoglobin and erythropoietin resistance index (ERI)] were recorded. Baseline analysis included group differences analysed using an independent t-test, dichotomized values using the χ2 test and prevalence were reported using the Statistical Package for the Social Sciences 24 (IBM, Armonk, NY, USA). Longitudinal analysis was conducted using repeated measures analysis. Results: A total of 106 patients (30 females and 76 males) were recruited with a mean age of 67.6 years [standard deviation (SD) 13.18] and dialysis vintage of 4.92 years (SD 6.12). At baseline, 17 patients were identified as cachectic, having had reported weight loss (e.g. >5% for >6 months) or BMI <20 kg/m2 and three or more clinical characteristics of cachexia. Seventy patients were available for analysis at 12 months (11 cachectic versus 59 not cachectic). FAACT and urea reduction ratio statistically distinguished cachectic patients (P = 0.001). However, measures of weight, BMI, MUAMC, HGS, CRP, ERI and FACIT tended to worsen in cachectic patients. Conclusion: Globally, cachexia is a severe but frequently underrecognized problem. This is the first study to apply the defined characteristics of cachexia to a representative sample of patients receiving HD. Further, more extensive studies are required to establish a phenotype of cachexia in advanced CKD.

Item Type:Article
Additional Information:A correction has been published: Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Page 1554,
Uncontrolled Keywords:cachexia; definition; haemodialysis; longitudinal analysis; phenotype; Aged; Aged, 80 and over; Cachexia; Female; Hand Strength; Humans; Kidney Diseases; Longitudinal Studies; Male; Middle Aged; Renal Dialysis
Group:Faculty of Health & Social Sciences
ID Code:38607
Deposited By: Symplectic RT2
Deposited On:06 Jun 2023 14:10
Last Modified:06 Jun 2023 14:10


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