Prevalence and Prognostic Significance of Malnutrition in Chronic Renal Insufficiency

Lawson, J A; Lazarus, Ross; Kelly, John J.

doi:10.1016/s1051-2276(01)85914-8

Cited by 102 publications

(75 citation statements)

References 28 publications

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“…The prevalence of malnutrition in previous reports varied widely between 28-65%. [9][10][11][12][13] This is due to differences in these studies in terms of criteria used in diagnosis and study subjects whether they were on maintenance dialysis or not.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of malnutrition in previous studies varied between 28-65% depending on criteria used in diagnosis. [9][10][11][12][13] Majority of previous studies on malnutrition were carried out in end stage renal disease (ESRD) patients who were already on renal replacement therapy (RRT) with only a few in pre-dialysis ESRD patients. The causes of malnutrition in CKD are multi-factorial and include reduced food intake due to effect of uremia, reduced absorption of nutrients from oedematous gut, metabolic acidosis, increased protein loss during dialysis especially peritoneal dialysis, inflammation, oxidative stress, carbonyl stress and hormonal disorders.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition in pre-dialysis chronic kidney disease patients in a teaching hospital in Southern Nigeria

Adejumo¹,

Enajite²

2016

Afr H. Sci.

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Background: Malnutrition is a complication in chronic kidney disease (CKD) known to affect quality of life and prognosis although not often diagnosed. It is associated with rapid progression to end stage renal disease (ESRD) and mortality. Early identification and treatment will slow down progression to ESRD and mortality. Objective: To determine the prevalence and pattern of malnutrition in pre-dialysis CKD patients in Southern Nigeria. Methods: One hundred and twenty consecutive pre-dialysis CKD and 40 control subjects without CKD were studied. Data obtained from participants were demographics, body mass index (BMI), and aetiology of CKD. Indices used to assess presence of malnutrition were low BMI, hypocholesterolaemia and hypoalbuminaemia. Statistical significance was taken at 0.05 level. Results: The mean age of the CKD subjects was 48.8±16.6years with a male: female ratio of 1.7:1. Prevalence of malnutrition in the CKD subjects was 46.7%, higher than 27.5% observed in the controls (p=0.033). Prevalence of malnutrition increased significantly across CKD stages 2 to 5 (p=0.020). It was significantly commoner in elderly patients (p=0.047) but not significantly different between males and females(p=0.188). Conclusion: Malnutrition is common in pre-dialysis CKD patients even in early CKD stages. Prevalence of malnutrition increases with worsening kidney function and increasing age.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malnutrition in pre-dialysis chronic kidney disease patients in a teaching hospital in Southern Nigeria

Adejumo¹,

Enajite²

2016

Afr H. Sci.

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“…A large proportion of patients on maintenance hemodialysis (HD) have PEM, and this condition is strongly associated with increased morbidity and mortality. [1][2][3] Reduced protein energy intake, adverse dialysis-related events, chronic inflammation, and concomitant acute and chronic illness are the main factors responsible for malnutrition in HD patients. [4][5][6][7][8][9][10] Obesity has been identified as an independent risk factor for cardiovascular disease in the general population.…”

Section: Introductionmentioning

confidence: 99%

Increased Body Mass Index Is Not a Reliable Marker of Good Nutrition in Hemodialysis Patients

et al. 2007

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Objective. The aim of the study was to assess the body fat (BF) composition in hemodialysis (HD) patients using anthropometry and bioelectrical impedance analysis (BIA) and investigate relationships between BIA-determined BF composition and nutritional parameters in different weight groupings. Design. Cross-sectional study. Setting. A tertiary-care university hospital. Methods. 164 HD patients (M/F: 89/75, mean age: 48.4 ± 15.8 years, mean HD duration: 58.2 ± 42.6 months) were divided into three groups according to body mass index (BMI): normal weight (NW: BMI 18.5-24.9), overweight (OW: BMI 25-29.9), obese (OB, BMI ≥ 30). Biochemical parameters and BF composition using anthropometry and foot-to-foot BIA were compared between three groups. Results. Ninety-six (59%) patients were NW, 40 (24%) were OW, and 28 (17%) were OB. Average mean skinfold thickness (p = 0.005), mid-arm circumference (p = 0.001), BF% (p = 0.001), and fat-free mass (FFM) (p = 0.03) were all significantly greater in the OB group than in the NW group. Compared to the NW patients, the OB group had significantly higher serum levels of glucose (p = 0.03), total cholesterol (p = 0.02), and triglycerides (p = 0.02), but significantly lower serum albumin (p = 0.05) and blood urea nitrogen (p = 0.05). The OB group also had significantly higher white blood cell count (p=0.002) and serum CRP (p = 0.001) than the NW group. Conclusions. The results suggest that BIA-determined BF composition is correlated with body mass index. In addition, obesity is associated with elevated CRP and white blood cell count and lower serum albumin level in HD patients.

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“…generally, without including a control group (8,13). Furthermore, different methods were used, such as selected laboratory tests (5-13), evaluation of hand-grip strength (29), subjective global assessment (7,8), anthropometry (12), and dual-energy x-ray absorptiometry (10). Previous studies have demonstrated that renal failure is a strong and independent risk factor for malnutrition, especially for GFR Ͻ30 ml/min per 1.73 m 2 (6,9).…”

Section: Discussionmentioning

confidence: 99%

Early Changes in Bioelectrical Estimates of Body Composition in Chronic Kidney Disease

Bellizzi

Scalfi²,

Terracciano³

et al. 2006

Journal of the American Society of Nephrology

110

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The aim of this study was to detect the potential occurrence of early abnormalities of body composition in patients with chronic kidney disease (CKD) at first referral to an outpatient nephrology clinic. Eighty-four patients with CKD (49 men and 35 women) were compared with 604 healthy control subjects (298 men and 306 women). Anthropometry and bioelectrical impedance analysis (BIA) were performed in all participants, whereas renal function, laboratory tests for nutritional status, and nutrient intake were assessed in the CKD group only. Creatinine clearance was 27.8 ؎ 13.8 and 27.4 ؎ 13.0 ml/min per 1.73 m 2 in male and female patients with CKD, respectively. No patient showed peripheral edema; frank malnutrition, defined by presence of serum albumin <3.5 g/dl plus body mass index <20 kg/m 2 ; or protein intake <0.6 g/kg per d. At the BIA, patients with CKD showed lower resistance (R) and abnormal mean impedance vectors for the bivariate normal distribution of R/height and reactance/height. Phase angle also was reduced (؊22%), especially in patients with diabetes. When BIA-derived data were considered, total body water was slightly higher (؉4.3% in men; ؉3.5% in women) and body cell mass was lower (؊6.7% in men; ؊7.7% in women) in patients with CKD. No difference in either BIA parameters or nutritional indexes was observed among various CKD stages. Despite the absence of overt malnutrition, patients with CKD exhibit altered BIA variables from the early phases of renal disease. These alterations are related to the renal dysfunction, are more marked in the presence of diabetes, and mainly indicate the presence of overhydration in the absence of edema. Therefore, BIA represents an attractive clinical tool to detect impairment of body composition from the early stages of CKD.

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Prevalence and Prognostic Significance of Malnutrition in Chronic Renal Insufficiency

Cited by 102 publications

References 28 publications

Malnutrition in pre-dialysis chronic kidney disease patients in a teaching hospital in Southern Nigeria

Malnutrition in pre-dialysis chronic kidney disease patients in a teaching hospital in Southern Nigeria

Increased Body Mass Index Is Not a Reliable Marker of Good Nutrition in Hemodialysis Patients

Early Changes in Bioelectrical Estimates of Body Composition in Chronic Kidney Disease

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