TABLE 2.
Multivariable-adjusted hazard ratios (and 95% CIs), attributable fractions, and population attributable fractions for all-cause mortality and the composite outcome of predialysis all-cause mortality or end-stage renal disease associated with the number of markers of malnutrition or inflammation below or above the median value1
| Risk associated with number of PEW markers present |
|||
| 1 (n = 447) vs 0 (n = 212) | 2 (n = 401) vs 0 (n = 212) | 3 (n = 160) vs 0 (n = 212) | |
| All-cause mortality | |||
| Hazard ratio (95% CI) | |||
| Fixed-covariate | 1.3 (1.0, 1.7) | 1.7 (1.3, 2.2) | 2.1 (1.5, 2.9) |
| Time-dependent | 1.7 (1.2, 2.4) | 2.4 (1.7, 3.4) | 3.6 (2.5, 5.1) |
| Composite outcome | |||
| Hazard ratio (95% CI) | |||
| Fixed-covariate | 1.1 (0.9, 1.5) | 1.5 (1.2, 1.9) | 1.7 (1.3, 2.3) |
| Time-dependent | 1.8 (1.3, 2.5) | 2.5 (1.8, 3.4) | 3.4 (2.4, 4.7) |
| Attributable fraction | |||
| Mortality percent (95% CI) | |||
| Fixed-covariate | 22 (−1, 41) | 43 (26, 57) | 60 (45, 70) |
| Time-dependent | 39 (13, 58) | 66 (53, 76) | 80 (71, 86) |
| Composite outcome percent (95% CI) | |||
| Fixed-covariate | 26 (5, 42) | 45 (30, 58) | 59 (45, 70) |
| Time-dependent | 42 (21, 58) | 66 (54, 75) | 77 (69, 84) |
| Population attributable fraction | |||
| Mortality percent (95% CI) | |||
| Fixed-covariate | 16 (5, 25) | 27 (18, 35) | 22 (15, 39) |
| Time-dependent | 35 (15, 50) | 57 (43, 68) | 65 (54, 73) |
| Composite outcome percent (95% CI) | |||
| Fixed-covariate | 17 (8, 24) | 26 (19, 33) | 19 (13, 25) |
| Time-dependent | 40 (24, 52) | 59 (48, 68) | 64 (54, 71) |
Markers of protein-energy wasting (PEW) were defined as serum albumin <3.7 g/dL, percentage of lymphocytes in white blood cell (WBC) count <22%, and WBC count >7500/mm3. Hazard ratios were determined in fixed covariate and time-dependent Cox models using the group with no markers of PEW as referent. All Cox models were adjusted for age, race, Charlson comorbidity index, etiology of chronic kidney disease, diabetes mellitus, cardiovascular disease, smoking, systolic and diastolic blood pressure, BMI, estimated glomerular filtration rate, serum calcium, serum phosphorus, hemoglobin, bicarbonate, blood cholesterol, and 24-h urinary protein. Attributable factions were calculated based on incidence rate differences, and population attributable fractions were estimated from Poisson regressions.