Hydration measured by doubly labeled water in ALS and its effects on survival

for the ALS Nutrition-NIPPV Study Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)220-231
Number of pages12
JournalAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Volume19
Issue number3-4
DOIs
StatePublished - Apr 3 2018

Fingerprint

Drinking
Survival
Water
Body Water
Centers for Medicare and Medicaid Services (U.S.)
Malnutrition
Multicenter Studies

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

@article{106de84ef12144ba88098ba6119b8949,
title = "Hydration measured by doubly labeled water in ALS and its effects on survival",
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.",
author = "{for the ALS Nutrition-NIPPV Study Group} and Scagnelli, {Connor N.} and Howard, {Diantha B.} and Bromberg, {Mark B.} and Kasarskis, {Edward J.} and Matthews, {Dwight E.} and Mitsumoto, {Hiroshi M.} and Zachary Simmons and Rup Tandan",
year = "2018",
month = "4",
day = "3",
doi = "10.1080/21678421.2017.1413117",
language = "English (US)",
volume = "19",
pages = "220--231",
journal = "Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration",
issn = "2167-8421",
publisher = "Informa Healthcare",
number = "3-4",

}

Hydration measured by doubly labeled water in ALS and its effects on survival. / for the ALS Nutrition-NIPPV Study Group.

In: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, Vol. 19, No. 3-4, 03.04.2018, p. 220-231.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hydration measured by doubly labeled water in ALS and its effects on survival

AU - for the ALS Nutrition-NIPPV Study Group

AU - Scagnelli, Connor N.

AU - Howard, Diantha B.

AU - Bromberg, Mark B.

AU - Kasarskis, Edward J.

AU - Matthews, Dwight E.

AU - Mitsumoto, Hiroshi M.

AU - Simmons, Zachary

AU - Tandan, Rup

PY - 2018/4/3

Y1 - 2018/4/3

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85038108571&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038108571&partnerID=8YFLogxK

U2 - 10.1080/21678421.2017.1413117

DO - 10.1080/21678421.2017.1413117

M3 - Article

C2 - 29243507

AN - SCOPUS:85038108571

VL - 19

SP - 220

EP - 231

JO - Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

JF - Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

SN - 2167-8421

IS - 3-4

ER -