Prevalence and Risk of Protein-Energy Wasting Assessed by Subjective Global Assessment in Older Adults With Advanced Chronic Kidney Disease: Results From the EQUAL Study

Windahl, Karin; Irving, Gerd Faxén; Almquist, Tora; Lidén, Maarit Korkeila; Luijtgaarden, Moniek van de; Chesnaye, Nicholas C.; Voskamp, Pauline; Stenvinkel, Peter; Klinger, Marian; Szymczak, Maciej; Torino, Claudia; Postorini, Maurizio; Drechsler, Christiane; Caskey, Fergus; Wanner, Christoph; Dekker, Friedo W.; Jager, Kitty J.; Evans, Marie

doi:10.1053/j.jrn.2017.11.002

Cited by 46 publications

(39 citation statements)

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“…For patients on hemodialysis, assessment should be preferably performed before the dialysis session when handgrip strength was shown to be higher than after the dialysis session [169] c Each test is scored in 0 to 4 and the maximum score is 12 [170] [53]. Hence, aging adds up as a contributing factor to the etiology of sarcopenia in CKD.…”

Section: Sarcopenia and Ckdmentioning

confidence: 99%

Sarcopenia in chronic kidney disease: what have we learned so far?

et al. 2020

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The term sarcopenia was first introduced in 1988 by Irwin Rosenberg to define a condition of muscle loss that occurs in the elderly. Since then, a broader definition comprising not only loss of muscle mass, but also loss of muscle strength and low physical performance due to ageing or other conditions, was developed and published in consensus papers from geriatric societies. Sarcopenia was proposed to be diagnosed based on operational criteria using two components of muscle abnormalities, low muscle mass and low muscle function. This brought awareness of an important nutritional derangement with adverse outcomes for the overall health. In parallel, many studies in patients with chronic kidney disease (CKD) have shown that sarcopenia is a prevalent condition, mainly among patients with end stage kidney disease (ESKD) on hemodialysis (HD). In CKD, sarcopenia is not necessarily age-related as it occurs as a result of the accelerated protein catabolism from the disease and from the dialysis procedure per se combined with low energy and protein intakes. Observational studies showed that sarcopenia and especially low muscle strength is associated with worse clinical outcomes, including worse quality of life (QoL) and higher hospitalization and mortality rates. This review aims to discuss the differences in conceptual definition of sarcopenia in the elderly and in CKD, as well as to describe etiology of sarcopenia, prevalence, outcome, and interventions that attempted to reverse the loss of muscle mass, strength and mobility in CKD and ESKD patients.

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Section: Sarcopenia and Ckdmentioning

confidence: 99%

Sarcopenia in chronic kidney disease: what have we learned so far?

et al. 2020

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“…Elderly patients with CKD were more likely to suffer mortality than to progress to end-stage renal disease (ESRD) due to complications and comorbidities 6,7. They also had a high prevalence of geriatric syndromes, including depression, cognitive impairment and malnutrition 8–10…”

Section: Introductionmentioning

confidence: 99%

<p>The prevalence of depression and the association between depression and kidney function and health-related quality of life in elderly patients with chronic kidney disease: a multicenter cross-sectional study</p>

Wang

Liang

Zhu

et al. 2019

CIA

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Purpose: The prevalence of depression and the relationship between depression and kidney function and health-related quality of life (HRQOL) are not well understood in elderly patients with predialysis chronic kidney disease (CKD). This study aimed to evaluate the prevalence of depression and the association between depression and kidney function and HRQOL. Patients and methods: In this cross-sectional study, 1079 elderly participants with CKD were recruited at 32 clinical centers located within 26 cities throughout 24 provinces in China. Demographic information and laboratory analyses were collected. Symptoms of depression were assessed using the 15-item Geriatric Depression Scale (GDS-15). HRQOL was evaluated using the Kidney Disease Quality of Life-36 (KDQOL-36) instrument. Results: The prevalence of depression was 23.0%. The estimated glomerular filtration rate (eGFR) was negatively correlated with the GDS score whether it was treated as a categorical variable (r=−0.097, P =0.001) or as a continuous variable (r=−0.100, P =0.001). Marital status, education level, history of CVD and diabetes, CKD stage and proteinuria confirmed to be independent and significant predictors of depression in patients with CKD. Compared with CKD 1–2 patients, we observed an increase of 0.541 and 4.171 in the odds for developing depression in patients CKD 4 (odds ratio [OR] =1.541; P =0.031) and CKD 5 (odds ratio [OR] =5.171; P <0.001), respectively. We observed negative and significant correlations with the GDS score for the following components: PCS (r=−0.370, P <0.001), MCS (r=−0.412, P <0.001), burden of kidney disease (r=−0.403, P <0.001), symptoms and problems of kidney disease (r=−0.360, P <0.001) and effects of kidney disease (r=−0.355, P <0.001). Depression was an independent and significant predictor of all the subcomponents of the HRQOL. Conclusions: The prevalence of depression in elderly patients with CKD was high and was negatively correlated with kidney function. Depression had a major negative impact on HRQOL.

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“…In a study conducted in six European countries, it was reported that among older patients (aged >65 years) with an advanced stage of kidney disease the prevalence of PEW is quite high as assessed by the 7-point SGA rating. Loss of fat tissue and muscle wasting was more common in patients aged more than 80 years 32 . Similarly reported in 2017 Campbell studied that SGA can effectively predict the risk of mortality among dialysis and non-dialysis CKD patients 33. In 2001 Kalantar studied serum albumin level was lower in SGA malnourished patients receiving continuous ambulatory dialysis 34 .…”

Section: Pg-sga In Chronic Kidney Diseasementioning

confidence: 98%

Patient-Generated Subjective Global Assessment (Pg-Sga): A Review

Maurya¹

2018

Int. Res. J. Pharm.

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The present investigation, Subjective Global Assessment (SGA) and its different variants are being widely used as a nutritional status or risk assessment tool in clinical and hospital practice for myriads of disease including life-threatening one such as cancer, chronic kidney diseases. SGA is based on measurement and observation of several parameters such as weight change, dietary intake change, gastrointestinal symptoms, functional capacity, co morbidities related to nutritional condition and physical examination. However, the tool is not devoid of limitation and is being constantly improved for the optimization of its use in various other diseases. Therefore, clinicians need an easy to use and interpret, low cost, reliable tool to assess nutritional status. The PG-SGA is a more sensitive tool than other versions of SGA and is successfully being used as a screening tool in diseases like cancer, tuberculosis, HIV and chronic kidney disease (CKD) etc. According to the theory of "reverse epidemiology", a patient with better nutritional status is supposed to have increased scope of survival. Therefore, it is increasingly being used patients who are at the pre-dialysis stage or being treated with dialysis. The review will summarize the basics of the nutritional assessment tool, its indications, and limitation of use in clinical practice etc. Moreover, the review will summarize the recommendations for use of PG-SGA in CKD and a brief review of existing literature to understand the scope of use and future perspective of the application of this tool for using in CKD patient population.

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Prevalence and Risk of Protein-Energy Wasting Assessed by Subjective Global Assessment in Older Adults With Advanced Chronic Kidney Disease: Results From the EQUAL Study

Cited by 46 publications

References 47 publications

Sarcopenia in chronic kidney disease: what have we learned so far?

Sarcopenia in chronic kidney disease: what have we learned so far?

<p>The prevalence of depression and the association between depression and kidney function and health-related quality of life in elderly patients with chronic kidney disease: a multicenter cross-sectional study</p>

Patient-Generated Subjective Global Assessment (Pg-Sga): A Review

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