Protein Energy Wasting in Patients with Chronic Renal Disease in Stage III to IV Caldas (Colombia)
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Keywords

Protein deficiency, chronic kidney disease, protein energy malnutrition.

How to Cite

1.
Ramírez Castaño J, Restrepo Valencia CA, González Correa CH, Marulanda Mejía F, Chacón Cardona JA. Protein Energy Wasting in Patients with Chronic Renal Disease in Stage III to IV Caldas (Colombia). Rev. Colomb. Nefrol. [Internet]. 2020 Aug. 5 [cited 2024 Apr. 19];7(2). Available from: https://revistanefrologia.org/index.php/rcn/article/view/408

Abstract

Introduction: Chronic kidney disease (CKD) is a condition that is recognized as a global health problem and has an approximate prevalence of 7.2% in developed countries, and 10% in the world population, it is also an independent factor of cardiovascular morbidity and risk characterized by progressive loss of kidney function.

Objective: To evaluate the frequency of DPE in patients with CKD stages III to IV.

Methods: Descriptive, cross-sectional study. Evaluation of a database of patients with CKD, which will have sociodemographic, biochemical variables, Subjective Global Assessment (VGS), and anthropometric measures, for the diagnosis of DPE of the International Society for Nutrition and Renal Metabolism.

Results: Of 200 reviewed patients from the Nephrology outpatient clinic, 60 met the inclusion criteria. The average age was 68.4 years, with a mean glomerular filtration rate (GFR) of 47.1ml / min. Regarding CKD, 61.66% (37) of the patients classified in stage IIIa, 31.6% (19) in stage IIIb, and 6.66% (4) in stage IV. None of the patients met the criteria for DPE. The VGS evaluation showed that 53.33% (32) of the patients were in the VGS A category (well nourished), 45% (27) VGS B (moderate malnutrition) and only one patient was classified as VGS C (severe malnutrition). The highest proportion of patients with low levels of albumin and cholesterol was in patients with CKD stage IIIb, and patients with BMI less than 23 in stages IIIb and IV.

Conclusion: According to the criteria of the International Society for Renal Nutrition and Metabolism, no patient had DPE.outpatient clinic in Caldas, with CKD stages III to IV-. METHODS: Descriptive, cross-sectional study. Evaluation of a database of patients with CKD, which will have sociodemographic, biochemical variables, Subjective Global Assessment (SGA), and anthropometric measures, for the diagnosis of PEW of the International Society for Nutrition and Renal Metabolism. RESULTS: Of 200 reviewed patients from the Nephrology outpatient clinic, 60 met the inclusion criteria. The average age was 68.4 years, with a mean glomerular filtration rate (GFR) of 47.1ml / min. Regarding CKD, 61.66% (37) of the patients were classified in stage IIIa, 31.6% (19) in stage IIIb, and 6.66% (4) in stage IV. None of the patients met the criteria for PEW. The SGA evaluation showed that 53.33% (32) of the patients were in SGA A category (well nourished), 45% (27) SGA B (moderate malnutrition) and only one patient was classified as SGA C (severe malnutrition). The highest proportion of patients with low albumin and cholesterol levels was in patients with CKD in stage IIIb, and patients with BMI less than 23 in stages IIIb and IV.

Conclusion: According to the criteria of the International Society for Nutrition and Renal Metabolism, no patient had PEW.

https://doi.org/10.22265/acnef.7.2.408
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References

Zhang QL, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies?: Systematic review. BMC Public Health. 2008;8:117. https://dx.doi.org/10.1186/1471-2458-8-117.

Otero A, de Francisco ALM , Gayoso P, García F. Prevalence of chronic renal disease in Spain?: Results of the EPIRCE study. Nefrologia. 2010;30(1):78-86.

Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, et al. Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease: A Consensus Statement From the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr. 2013;23(2):77-90. https://dx.doi.org/10.1053/j.jrn.2013.01.001.

GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33. https://dx.doi.org/10.1016/S0140-6736(20)30045-3.

Palmer SC, Ruospo M, Campbell KL, Garcia-Larsen VG, Saglimbene V, Natale P, et al. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: Protocol for DIET-HD, a prospective multinational cohort study. BMJ Open. 2015;5(3):e006897. https://dx.doi.org/10.1136/bmjopen-2014-006897.

Martínez-Castelao A, Górriz-Teruel JL, Bover-Sanjuán J, Segura-de la Morena J, Cebollada J, Escalada J, et al. Documento de consenso para la detección y manejo de la enfermedad renal crónica. Nefrologia. 2014;34(2):243-62. https://dx.doi.org/10.3265/Nefrologia.pre2014.Feb.12455.

Aggarwal HK, Jain D, Chauda R, Bhatia S, Sehgal R. Assessment of Malnutrition Inflammation Score in Different Stages of Chronic Kidney Disease. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2019;39(2-3):51-61. https://dx.doi.org/10.2478/prilozi-2018-0042.

Kalantar-Zadeh K, Fouque D. Nutritional Management of Chronic Kidney Disease. N Engl J Med. 2017;377:1765-76. https://dx.doi.org/10.1056/NEJMra1700312.

National Kidney Foundation. Clinical practice guideline for nutrition in chronic kidney disease?: 2019 update. Eat right; 2019.

Obi Y, Qader H, Kovesdy CP, Kalantar-Zadeh K. Latest consensus and update on protein-energy wasting in chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2015;18(3):254-62. https://dx.doi.org/10.1097/MCO.0000000000000171.

Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391-8. http://dx.doi.org/10.1038/sj.ki.5002585.

Namuyimbwa L, Atuheire C, Okullo J, Kalyesubula R. Prevalence and associated factors of protein-energy wasting among patients with chronic kidney disease at Mulago hospital, Kampala-Uganda: A cross-sectional study. BMC Nephrol. 2018;19(1):139. http://dx.doi.org/10.1186/s12882-018-0920-7.

Lawson JA, Lazarus R, Kelly JJ. Prevalence and prognostic significance of malnutrition in chronic renal insufficiency. J Ren Nutr. 2001;11(1):16-22. http://dx.doi.org/10.1016/s1051-2276(01)85914-8.

Koppler JD. National Kidney Foundation K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2000;37(1 Suppl 2):S66-70. http://dx.doi.org/10.1053/ajkd.2001.20748.

KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150.

Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is Subjective Global Assessment of Nutritional Status? JPEN J Parenter Enter Nutr. 1987;11(1):8-13. http://dx.doi.org/10.1177/014860718701100108.

Makhija S, Baker J. The subjective global assessment: A review of its use in clinical practice. Nutr Clin Pract. 2008;23(4):405-9. http://dx.doi.org/10.1177/0884533608321214.

Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 Years. Br J Nutr. 1974;32(01):77-97. http://dx.doi.org/10.1079/bjn19740060.

Hyun YY, Lee KB, Han SH, Kim YH, Kim YS, Lee SW, et al. Nutritional status in adults with predialysis chronic kidney disease: KNOW-CKD study. J Korean Med Sci. 2017;32(2):257-63. http://dx.doi.org/10.3346/jkms.2017.32.2.257.

Carrero JJ, Thomas F, Nagy K, Arogundade F, Avesani CM, Chan M, et al. Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism. Ren Nutr. 2018;28(6):380-92. https://dx.doi.org/10.1053/j.jrn.2018.08.006.

Beddhu S, Chen X, Wei G, Raj D, Raphael KL, Boucher R, et al. Associations of Protein-Energy Wasting Syndrome Criteria With Body Composition and Mortality in the General and Moderate Chronic Kidney Disease Populations in the United States. Kidney Int Reports. 2017;2(3):390-9. http://dx.doi.org/10.1016/j.ekir.2017.01.002.

Chao CT, Tang CH, Cheng RWY, Wang MYH, Hung KY. Protein-energy wasting significantly increases healthcare utilization and costs among patients with chronic kidney disease: a propensity-score matched cohort study. Curr Med Res Opin. 2017;33(9):1705-13. http://dx.doi.org/10.1080/03007995.2017.1354823.

Yamada S, Tokumoto M, Tatsumoto N, Taniguchi M, Noguchi H, Nakano T, et al. Phosphate overload directly induces systemic inflammation and malnutrition as well as vascular calcification in uremia. Am J Physiol Ren Physiol. 2014;306(12):1418-28. http://dx.doi.org/10.1152/ajprenal.00633.2013.

Ikizler TA. A patient with CKD and poor nutritional status. Clin J Am Soc Nephrol. 2013;8(12):2174-82. http://dx.doi.org/10.2215/CJN.04630513.

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