Background: Malnutrition is one of the most serious complications of chronic kidney disease due to its devastating consequences in terms of quality of life, morbidity, hospitalization and mortality. This study aims to evaluate the prevalence of malnutrition among chronic kidney disease patients globally and its contrast with India. Methods: Articles reporting the prevalence of malnutrition associated with CKD patients were retrieved from PubMed/Medline, ScienceDirect, Cochrane library & Google scholar. The quality assessment of studies was performed by using Newcastle-Ottawa scale. The pooled prevalence was reported with effect size considering the random effect model using comprehensive meta-analysis version 2.0. Results: The results from 61 observational studies containing 21119 patients are presented. The global prevalence of malnutrition associated with CKD was found to be 42.7%. The prevalence of malnutrition in peritoneal dialysis group was found to be (45.3%, 95%CI; 29.5-62.1) higher as compared to hemodialysis group (43.1%, 95% CI; 32.2-54.7) followed by non-dialysis group (38.5%, 95% CI; 24.0-55.3). The prevalence of malnutrition in India was found to be 56.7% (95% CI: 42.4-70.0%). Males were predominantly affected with malnutrition as compared to females. The prevalence in India was reported to be higher as compared to all the included countries, except Mexico and Jordan. Conclusions: Globally, India occupies the highest share of prevalence studies followed by Brazil. The geographical stratification of results revealed that the highest prevalence of malnutrition was observed in India except Mexico and Jordan. Given the high prevalence of malnutrition among CKD patients, evaluation of interventions for malnutrition with patient centered outcomes are warranted.

Aim: Hyperuricemia as a putative risk factor for chronic kidney disease (CKD) progression remains controversial and debatable. This systematic review aims to explore the prevalence of hyperuricemia among CKD patients worldwide. Methods: This study was conducted in accordance with the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines by using the existing literature from online databases such as MEDLINE/PubMed, ScienceDirect, Google Scholar, Cochrane library and grey literature. The effect size with corresponding 95% confidence interval (CI) was calculated to assess the pooled prevalence of hyperuricemia in chronic kidney patients. The subgroup analysis based on gender and geography was also carried out by utilizing comprehensive meta-analysis, version 2.0. Results: Twenty-three studies containing 212,740 participants were eligible for quantitative synthesis. The pooled prevalence of 43.6% (35.2–52.4%) hyperuricemia was reported in patients with CKD globally. In India, 38.4% of prevalence was observed. The gender specific prevalence (9 studies) was reported as 67.4% (60.9–73.3%) in case of male patients and 32.6% (26.7–39.1%) in female patients with 95% CI. Conclusions: The prevalence of hyperuricemia was reported to be reasonably high among CKD patients worldwide. During the management of CKD, this high prevalence demands more prudent attention for this clinical complication which possibly can lead to positive renal outcomes.

A B S T R A C TAim: The negative outcomes like an increased risk of falling, anemia, immune dysregulation, impaired cognitive status, reduced muscle function, increased morbidity and mortality associated with malnutrition are believed to affect the economy of the country in the future years. In this backdrop, this study aims to evaluate the nutritional status and different risk factors associated with malnutrition among elderly patients at a tertiary care public teaching hospital. Methods: This questionnaire-based study utilized the "Mini Nutritional Assessment-Short Form" tool to evaluate the nutritional status of elderly inpatients (aged 60 years or more). The data obtained from 235 participants reporting in the medicine department is presented. Based upon MNA-SF tool parameters, a well-determined score was obtained and on the basis of scores, the patients were categorized into "normal" (12-14), "at risk of malnutrition" (8-11 points) and "malnourished" (0-7 points). Multinomial logistic regression was performed to study the influence of different determinants on the nutritional status among elderly inpatients. Results: The studied sample had a high frequency of 50.2% for the patients who are "at risk of malnutrition" and 46.4% of patients were "malnourished". Based on the evaluated scores of MNA-SF tool, this study also confirms that the mobility functions, the decline in food intake and weight loss are major risk factors for malnutrition. Conclusions: A very high prevalence of malnutrition was observed, in consonance with the previous reports. The findings also indicate that malnutrition is a multifactorial condition mostly associated with mobility dysfunction followed by somatic factors and socio-demographic factors. Further studies are required to map the risk factors in order to avoid the associated negative outcomes.

Objective: Obesity and diabetes mellitus are interconnected conditions that share a number of pathophysiological mechanisms such as dyslipidemia leading to cardiovascular complications. The present study was conducted to determine the individual and combined effect of diabetes mellitus and obesity on dyslipidemia and ultimately on silent coronary artery disease (CAD). Methods:The patients selected from urban and rural areas of Lahore were recruited on the basis of body mass index (BMI) and fasting blood sugar (FBS) and were classified in four groups: (Group A; obese-diabetic, Group B; non-obese and diabetic, Group C; obese and non-diabetic and Group D; non-obese and non-diabetic).Total lipid profile including total cholesterol, triglycerides, high density lipoproteins and low density lipoproteins were determined along with exercise tolerance test (ETT). Results:The results indicated that combined obesity and diabetes was the major cause of Dyslipaedemia and CAD followed by obesity and diabetes alone. Triglycerides and atherogenic level of HDL-C were more prevalent in obese-diabetic patients (group A) followed by obese (group C) and diabetic (group B) alone.However low density lipoprotein (LDL) was more significant in obese (group C) but the results were also comparable in all other groups. Conclusion:The result of ETT revealed that overall group A was more prone towards CAD as compared to group B and group C but there was a non-significant correlation between CAD and obesity/diabetes within all experimental groups. Moreover, the risk of dyslipidemia and CAD was non significantly higher in urban population than rural population.

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