Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements: secondary analysis from the Nutritional Support for African Adults Starting Antiretroviral Therapy (NUSTART) trial.
Identifieur interne : 000C14 ( PubMed/Corpus ); précédent : 000C13; suivant : 000C15Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements: secondary analysis from the Nutritional Support for African Adults Starting Antiretroviral Therapy (NUSTART) trial.
Auteurs : Andrea Mary Rehman ; Susannah Louise Woodd ; Douglas Corbett Heimburger ; John Robert Koethe ; Henrik Friis ; George Praygod ; Lackson Kasonka ; Paul Kelly ; Suzanne FilteauSource :
- The British journal of nutrition [ 1475-2662 ] ; 2017.
English descriptors
- KwdEn :
- Adult, Africa, Anti-HIV Agents (therapeutic use), Dietary Supplements, Electrolytes (blood), Female, Food, Formulated, HIV Infections (blood), HIV Infections (complications), HIV Infections (drug therapy), HIV Infections (mortality), Humans, Lipids, Male, Malnutrition (blood), Malnutrition (complications), Malnutrition (diet therapy), Minerals (blood), Minerals (therapeutic use), Phosphates (blood), Phosphorus (blood), Potassium (blood), Vitamins (therapeutic use), Water-Electrolyte Balance.
- MESH :
- chemical , blood : Electrolytes, Minerals, Phosphates, Phosphorus, Potassium.
- chemical , therapeutic use : Anti-HIV Agents, Minerals, Vitamins.
- blood : HIV Infections, Malnutrition.
- complications : HIV Infections, Malnutrition.
- diet therapy : Malnutrition.
- drug therapy : HIV Infections.
- mortality : HIV Infections.
- Adult, Africa, Dietary Supplements, Female, Food, Formulated, Humans, Lipids, Male, Water-Electrolyte Balance.
Abstract
Malnourished HIV-infected patients starting antiretroviral therapy (ART) are at high risk of early mortality, some of which may be attributed to altered electrolyte metabolism. We used data from a randomised controlled trial of electrolyte-enriched lipid-based nutritional supplements to assess the association of baseline and time-varying serum phosphate and K concentrations with mortality within the first 12 weeks after starting ART. Baseline phosphate results were available from 1764 patients and there were 9096 subsequent serum phosphate measurements, a median of 6 per patient. For serum K there were 1701 baseline and 8773 subsequent measures, a median of 6 per patient. Abnormally high or low serum phosphate was more common than high or low serum K. Controlling for other factors found to affect mortality in this cohort, low phosphate which had not changed from the previous time interval was associated with increased mortality; the same was not true for high phosphate or for high or low K. Both increases and decreases in serum electrolytes from the previous time interval were generally associated with increased mortality, particularly in the electrolyte-supplemented group. The results suggest that changes in serum electrolytes, largely irrespective of the starting point and the direction of change, were more strongly associated with mortality than were absolute electrolyte levels. Although K and phosphate are required for tissue deposition during recovery from malnutrition, further studies are needed to determine whether specific supplements exacerbate physiologically adverse shifts in electrolyte levels during nutritional rehabilitation of ill malnourished HIV patients.
DOI: 10.1017/S0007114517000721
PubMed: 28393746
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pubmed:28393746Le document en format XML
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7HT,UK.</nlm:affiliation></affiliation></author><author><name sortKey="Heimburger, Douglas Corbett" sort="Heimburger, Douglas Corbett" uniqKey="Heimburger D" first="Douglas Corbett" last="Heimburger">Douglas Corbett Heimburger</name><affiliation><nlm:affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</nlm:affiliation></affiliation></author><author><name sortKey="Koethe, John Robert" sort="Koethe, John Robert" uniqKey="Koethe J" first="John Robert" last="Koethe">John Robert Koethe</name><affiliation><nlm:affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</nlm:affiliation></affiliation></author><author><name sortKey="Friis, Henrik" sort="Friis, Henrik" uniqKey="Friis H" first="Henrik" last="Friis">Henrik Friis</name><affiliation><nlm:affiliation>3University of Copenhagen,1958 Copenhagen,Denmark.</nlm:affiliation></affiliation></author><author><name sortKey="Praygod, George" sort="Praygod, George" uniqKey="Praygod G" first="George" 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7HT,UK.</nlm:affiliation></affiliation></author><author><name sortKey="Woodd, Susannah Louise" sort="Woodd, Susannah Louise" uniqKey="Woodd S" first="Susannah Louise" last="Woodd">Susannah Louise Woodd</name><affiliation><nlm:affiliation>1London School of Hygiene & Tropical Medicine,London WC1E 7HT,UK.</nlm:affiliation></affiliation></author><author><name sortKey="Heimburger, Douglas Corbett" sort="Heimburger, Douglas Corbett" uniqKey="Heimburger D" first="Douglas Corbett" last="Heimburger">Douglas Corbett Heimburger</name><affiliation><nlm:affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</nlm:affiliation></affiliation></author><author><name sortKey="Koethe, John Robert" sort="Koethe, John Robert" uniqKey="Koethe J" first="John Robert" last="Koethe">John Robert Koethe</name><affiliation><nlm:affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</nlm:affiliation></affiliation></author><author><name sortKey="Friis, Henrik" sort="Friis, Henrik" uniqKey="Friis H" first="Henrik" last="Friis">Henrik Friis</name><affiliation><nlm:affiliation>3University of Copenhagen,1958 Copenhagen,Denmark.</nlm:affiliation></affiliation></author><author><name sortKey="Praygod, George" sort="Praygod, George" uniqKey="Praygod G" first="George" last="Praygod">George Praygod</name><affiliation><nlm:affiliation>4Mwanza Research Centre,National Institute for Medical Research,Mwanza,Tanzania.</nlm:affiliation></affiliation></author><author><name sortKey="Kasonka, Lackson" sort="Kasonka, Lackson" uniqKey="Kasonka L" first="Lackson" last="Kasonka">Lackson Kasonka</name><affiliation><nlm:affiliation>5University Teaching Hospital,Lusaka,Zambia.</nlm:affiliation></affiliation></author><author><name sortKey="Kelly, Paul" sort="Kelly, Paul" uniqKey="Kelly P" first="Paul" last="Kelly">Paul Kelly</name><affiliation><nlm:affiliation>5University Teaching Hospital,Lusaka,Zambia.</nlm:affiliation></affiliation></author><author><name sortKey="Filteau, Suzanne" sort="Filteau, Suzanne" uniqKey="Filteau S" first="Suzanne" last="Filteau">Suzanne Filteau</name><affiliation><nlm:affiliation>1London School of Hygiene & Tropical Medicine,London WC1E 7HT,UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The British journal of nutrition</title><idno type="eISSN">1475-2662</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Africa</term><term>Anti-HIV Agents (therapeutic use)</term><term>Dietary Supplements</term><term>Electrolytes (blood)</term><term>Female</term><term>Food, Formulated</term><term>HIV Infections (blood)</term><term>HIV Infections (complications)</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (mortality)</term><term>Humans</term><term>Lipids</term><term>Male</term><term>Malnutrition (blood)</term><term>Malnutrition (complications)</term><term>Malnutrition (diet therapy)</term><term>Minerals (blood)</term><term>Minerals (therapeutic use)</term><term>Phosphates (blood)</term><term>Phosphorus (blood)</term><term>Potassium (blood)</term><term>Vitamins (therapeutic use)</term><term>Water-Electrolyte Balance</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Electrolytes</term><term>Minerals</term><term>Phosphates</term><term>Phosphorus</term><term>Potassium</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term><term>Minerals</term><term>Vitamins</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>HIV Infections</term><term>Malnutrition</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>HIV Infections</term><term>Malnutrition</term></keywords><keywords scheme="MESH" qualifier="diet therapy" xml:lang="en"><term>Malnutrition</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Africa</term><term>Dietary Supplements</term><term>Female</term><term>Food, Formulated</term><term>Humans</term><term>Lipids</term><term>Male</term><term>Water-Electrolyte Balance</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Malnourished HIV-infected patients starting antiretroviral therapy (ART) are at high risk of early mortality, some of which may be attributed to altered electrolyte metabolism. We used data from a randomised controlled trial of electrolyte-enriched lipid-based nutritional supplements to assess the association of baseline and time-varying serum phosphate and K concentrations with mortality within the first 12 weeks after starting ART. Baseline phosphate results were available from 1764 patients and there were 9096 subsequent serum phosphate measurements, a median of 6 per patient. For serum K there were 1701 baseline and 8773 subsequent measures, a median of 6 per patient. Abnormally high or low serum phosphate was more common than high or low serum K. Controlling for other factors found to affect mortality in this cohort, low phosphate which had not changed from the previous time interval was associated with increased mortality; the same was not true for high phosphate or for high or low K. Both increases and decreases in serum electrolytes from the previous time interval were generally associated with increased mortality, particularly in the electrolyte-supplemented group. The results suggest that changes in serum electrolytes, largely irrespective of the starting point and the direction of change, were more strongly associated with mortality than were absolute electrolyte levels. Although K and phosphate are required for tissue deposition during recovery from malnutrition, further studies are needed to determine whether specific supplements exacerbate physiologically adverse shifts in electrolyte levels during nutritional rehabilitation of ill malnourished HIV patients.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28393746</PMID><DateCreated><Year>2017</Year><Month>04</Month><Day>10</Day></DateCreated><DateCompleted><Year>2017</Year><Month>07</Month><Day>19</Day></DateCompleted><DateRevised><Year>2017</Year><Month>07</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1475-2662</ISSN><JournalIssue CitedMedium="Internet"><Volume>117</Volume><Issue>6</Issue><PubDate><Year>2017</Year><Month>Mar</Month></PubDate></JournalIssue><Title>The British journal of nutrition</Title><ISOAbbreviation>Br. J. Nutr.</ISOAbbreviation></Journal><ArticleTitle>Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements: secondary analysis from the Nutritional Support for African Adults Starting Antiretroviral Therapy (NUSTART) trial.</ArticleTitle><Pagination><MedlinePgn>814-821</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1017/S0007114517000721</ELocationID><Abstract><AbstractText>Malnourished HIV-infected patients starting antiretroviral therapy (ART) are at high risk of early mortality, some of which may be attributed to altered electrolyte metabolism. We used data from a randomised controlled trial of electrolyte-enriched lipid-based nutritional supplements to assess the association of baseline and time-varying serum phosphate and K concentrations with mortality within the first 12 weeks after starting ART. Baseline phosphate results were available from 1764 patients and there were 9096 subsequent serum phosphate measurements, a median of 6 per patient. For serum K there were 1701 baseline and 8773 subsequent measures, a median of 6 per patient. Abnormally high or low serum phosphate was more common than high or low serum K. Controlling for other factors found to affect mortality in this cohort, low phosphate which had not changed from the previous time interval was associated with increased mortality; the same was not true for high phosphate or for high or low K. Both increases and decreases in serum electrolytes from the previous time interval were generally associated with increased mortality, particularly in the electrolyte-supplemented group. The results suggest that changes in serum electrolytes, largely irrespective of the starting point and the direction of change, were more strongly associated with mortality than were absolute electrolyte levels. Although K and phosphate are required for tissue deposition during recovery from malnutrition, further studies are needed to determine whether specific supplements exacerbate physiologically adverse shifts in electrolyte levels during nutritional rehabilitation of ill malnourished HIV patients.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rehman</LastName><ForeName>Andrea Mary</ForeName><Initials>AM</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-9967-5822</Identifier><AffiliationInfo><Affiliation>1London School of Hygiene & Tropical Medicine,London WC1E 7HT,UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Woodd</LastName><ForeName>Susannah Louise</ForeName><Initials>SL</Initials><AffiliationInfo><Affiliation>1London School of Hygiene & Tropical Medicine,London WC1E 7HT,UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heimburger</LastName><ForeName>Douglas Corbett</ForeName><Initials>DC</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-3551-9710</Identifier><AffiliationInfo><Affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koethe</LastName><ForeName>John Robert</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>2Vanderbilt University Medical Center,Nashville, TN 37232,USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Friis</LastName><ForeName>Henrik</ForeName><Initials>H</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-2848-2940</Identifier><AffiliationInfo><Affiliation>3University of Copenhagen,1958 Copenhagen,Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>PrayGod</LastName><ForeName>George</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>4Mwanza Research Centre,National Institute for Medical Research,Mwanza,Tanzania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kasonka</LastName><ForeName>Lackson</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>5University Teaching Hospital,Lusaka,Zambia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kelly</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>5University Teaching Hospital,Lusaka,Zambia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Filteau</LastName><ForeName>Suzanne</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>1London School of Hygiene & Tropical Medicine,London WC1E 7HT,UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>04</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Br J Nutr</MedlineTA><NlmUniqueID>0372547</NlmUniqueID><ISSNLinking>0007-1145</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004573">Electrolytes</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D008055">Lipids</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D008903">Minerals</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D010710">Phosphates</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance 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RefType="Cites"><RefSource>BMC Infect Dis. 2016 Oct 12;16(1):562</RefSource><PMID Version="1">27733134</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Clin Nutr. 2016 Feb;103(2):551-8</RefSource><PMID Version="1">26739034</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Public Health Nutr. 2013 Mar;16(3):549-58</RefSource><PMID Version="1">22691872</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2015 Apr 1;68(4):405-12</RefSource><PMID Version="1">25501607</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Trop Med Int Health. 2006 Dec;11(12):1849-57</RefSource><PMID Version="1">17176350</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS Res Hum Retroviruses. 2011 Nov;27(11):1149-55</RefSource><PMID Version="1">21417949</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2011;6(12):e28691</RefSource><PMID Version="1">22220193</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2008 Oct 1;22(15):1897-908</RefSource><PMID Version="1">18784453</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2010 Apr 1;53(4):507-13</RefSource><PMID Version="1">19730111</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000349" MajorTopicYN="N">Africa</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019587" MajorTopicYN="Y">Dietary Supplements</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004573" 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MajorTopicYN="N">Potassium</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014815" MajorTopicYN="N">Vitamins</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014882" MajorTopicYN="N">Water-Electrolyte Balance</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">ART antiretroviral therapy</Keyword><Keyword MajorTopicYN="N">DAIDA Division of AIDS</Keyword><Keyword MajorTopicYN="N">IQR interquartile range</Keyword><Keyword MajorTopicYN="N">LNS lipid-based nutritional supplement</Keyword><Keyword MajorTopicYN="N">LNS-VM lipid-based nutritional supplements fortified with vitamins and minerals</Keyword><Keyword MajorTopicYN="N">NUSTART Nutritional Support for African Adults Starting Antiretroviral Therapy</Keyword><Keyword MajorTopicYN="N">Antiretroviral therapy</Keyword><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Malnutrition</Keyword><Keyword MajorTopicYN="N">Phosphate</Keyword><Keyword MajorTopicYN="N">Potassium</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>4</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>7</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>4</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28393746</ArticleId><ArticleId IdType="pii">S0007114517000721</ArticleId><ArticleId IdType="doi">10.1017/S0007114517000721</ArticleId><ArticleId IdType="pmc">PMC5426318</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix 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