Why the study?
Data were lacking on the effects of combined autonomic neuropathy scores across multiple organ systems on mortality in dialysis patients.
Do higher Composite Autonomic Symptom Score 31 (COMPASS 31) autonomic neuropathy scores and elevated C-reactive protein levels predict 5-year mortality in chronic hemodialysis patients?
Do higher Composite Autonomic Symptom Score 31 (COMPASS 31) autonomic neuropathy scores and elevated C-reactive protein levels predict 5-year mortality in chronic hemodialysis patients?
The self-administered COMPASS 31 questionnaire effectively detects multi-organ autonomic neuropathy in chronic hemodialysis patients and identifies those at significantly higher risk of 5-year mortality independent of systemic inflammation (CRP), age, sex, and diabetes.
Answers are grounded in this paper and cite their sources.
Higher AN scores may flag mortality risk in dialysis; hypothesis-generating and requires validation before any practice change.
Background: Autonomic neuropathy (AN) is prevalent in diabetes and chronic kidney disease. The Composite Autonomic Symptom Score 31 (COMPASS 31) is a self-assessment test developed to determine not only cardiac AN but also AN of other organs, including the vasomotor, pupillomotor, secretomotor, and gastrointestinal systems. As yet there are no data on the effects of combined AN-scores of a variety of affected organ systems on mortality in dialysis patients. Methods: In 119 patients undergoing hemodialysis therapy, symptoms of AN were documented using COMPASS 31. After 5 years, survival rates were calculated depending on AN scores and other parameters. After this 5-year period, AN scores were assessed for a second time and correlated with those obtained 5 years earlier. Results: Survival rates for patients with lower AN scores were better than for those with higher AN scores. Patients with lower C-reactive protein levels showed better survival compared to those with higher values. Dialysis patients with diabetes had a lower survival rate compared to non-diabetic patients. In women, survival rates were better than in men. AN scores remained unchanged over the 5-year period. Conclusion: AN is frequently observed in dialysis patients and can be identified through the COMPASS 31 questionnaire. Patients with higher AN scores exhibit poorer survival rates compared to those with lower scores. This observation is applicable not only for cardiac AN but also to AN scores reflecting changes in other organ systems. Therefore, AN scores can be used effectively to detect various AN symptoms in dialysis patients and identify their increased risk of mortality.
No takes yet. Share an insight, caveat, or question.
Schramm et al. (2024) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: