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Hydration measured by doubly labeled water in ALS and its effects on survival.
- Source :
-
Amyotrophic lateral sclerosis & frontotemporal degeneration [Amyotroph Lateral Scler Frontotemporal Degener] 2018 May; Vol. 19 (3-4), pp. 220-231. Date of Electronic Publication: 2017 Dec 15. - Publication Year :
- 2018
-
Abstract
- We present a study of hydration in ALS patients and its effects on survival. This was a multicenter study over 48 weeks in 80 ALS patients who underwent 250 individual measurements using doubly labeled water (DLW). Total body water (TBW) and water turnover (a surrogate for water intake) were 3.4% and 8.6% lower, respectively, in patients compared to age- and gender-matched healthy controls, and both significantly decreased over study duration. In 20% of patients, water turnover measured over 10 d was 2 standard deviations below the mean value in healthy controls. In a separate clinic cohort of 208 patients, water intake estimated from a de novo equation created from common clinical endpoints was a prognostic indicator of survival. Regardless of nutritional state assessed by BMI, survival was two-fold longer in the group above the median for estimated water intake, suggesting that hydration may be a more important predictor of survival than malnutrition. Risk factors for poor hydration were identified. Water intake equations recommended by US Centers for Medicare and Medicaid Services in healthy elderly were inaccurate for use in ALS patients. We developed equations to estimate TBW and water intake in ALS patients for use in clinics to accurately estimate hydration and improve clinical care.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Basal Metabolism
Case-Control Studies
Cohort Studies
Disease Management
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Nutritional Requirements physiology
Risk Factors
Severity of Illness Index
Survival
Vital Capacity
Young Adult
Amyotrophic Lateral Sclerosis mortality
Amyotrophic Lateral Sclerosis physiopathology
Drinking physiology
Organism Hydration Status physiology
Water metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 2167-9223
- Volume :
- 19
- Issue :
- 3-4
- Database :
- MEDLINE
- Journal :
- Amyotrophic lateral sclerosis & frontotemporal degeneration
- Publication Type :
- Academic Journal
- Accession number :
- 29243507
- Full Text :
- https://doi.org/10.1080/21678421.2017.1413117