Diminished appetite predicts mortality of Chinese peritoneal dialysis patients

Background: Many maintenance dialysis patients experience a common cluster of symptoms, including diminished appetite (anorexia). This symptom has been associated with reduced quality of life and increased mortality in this population.

Aim: The aim of this study was to determine whether diminished appetite is a significant predictor of negative clinical outcomes in patients on peritoneal dialysis (PD).

Method: A longitudinal prospective study was conducted in 98 patients receiving PD in Beijing, China. Clinical characteristics, nutritional and inflammatory marker levels, and related peritoneal treatment information were collected. The appetite status and serum albumin levels were assessed initially and reevaluated monthly during the first year of follow-up. All patients were followed for nearly 5 years or until death. Data were collected about mortality, hospitalization, and peritonitis.

Results: The mean age of participants was 60.3 ± 14.4, and 22.8% reported diminished appetite. At baseline, female sex, cardiovascular disease, and prealbumin level were the significant predictors of appetite. The average length of follow-up was 39 (range: 2-57) months. The Kaplan-Meier survival curve showed the survival rate was lower in patients reporting diminished appetite than for patients reporting normal appetite. Multivariate analysis indicated that diminished appetite, diabetes, ferritin, and serum albumin levels were independent predictors of mortality.

Conclusion: Self-reported appetite was a predictor of clinical characteristics and outcome for patients receiving PD. Conducting appetite evaluation periodically is recommended as a nursing strategy to improve care for these patients.