Association between kidney function, nutritional status and anthropometric measures in older people

Abstract

Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.

Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh

“… 42 Therefore, it will be prudent to screen the elderly population to gather further evidence. Moreover, we observed that lower serum albumin levels are independently correlated with decreased renal function among our participants, which has also been reported in other studies, particularly in the elderly population, 43 Further study is required to understand the biological mechanisms that relate low serum albumin to decreased renal function.…”

Chronic Dehydration in Nursing Home Residents

“…We performed additional analysis to clarify the association between eGFR and other factors and found a negative correlation between eGFR and BMI ( Supplementary Material Table S1 ). This might be explained by the association between chronic kidney disease and obesity [ 54 ].…”

Percentual de gordura e índice de massa corporal predispõem portadores de doença renal crônica a variações em biomarcadores sanguíneos

“…A DRC é comumente relatada em indivíduos idosos, seja por decréscimo da TFG devido ao maior tempo de exposição à fatores de risco, devido à senescência ou aos processos fisiopatológicos (Fung & Tamura 2016). Guligowska et al (2020) através de análises antropométricas e nutricionais de indivíduos com mais de 75 anos com e sem DRC, demostrou que idosos com IMC elevado tinham maior associação para com DRC. Um elevado IMC e %GC em outros estudos foram apontados em portadores de DRC como potencial fator de risco para doença renal em estágio terminal (DRET) (Ahmadi et al, 2016), além de promoção para outras alterações clínicas, como redução da secreção de insulina, inflamação e dislipidemia, respectivamente (Kalantar-Zadeh et al, 2017).…”