Malnutrition risk correlates with kidney function decline, CKD among older adults
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Malnutrition is associated with poor kidney function, increased risk of kidney function decline and chronic kidney disease among older adults without advanced kidney disease, according to data published in the Journal of Renal Nutrition.
Further, researchers noted that physicians might consider using preventative interventions to lower malnutrition risk (MR) among patients in this population.
“The association of malnutrition with CKD is well known,” Yanxia Lu, PhD, from the Cheeloo College of Medicine at Shandong University in China, and colleagues wrote. “No longitudinal studies have yet shown whether MR predisposes to the kidney function decline or progression to early-stage CKD in community-dwelling older adults. Understanding the relationships between MR status and kidney function and the risk of kidney function decline and disease is requisite for recommending a preventive strategy among community-dwelling older adults for nutritional interventions which may potentially slow kidney function decline and prevent end-stage renal failure.”
Researchers evaluated the correlation of MR status with kidney function and the risks of kidney decline and CKD progression among 5,122 community-dwelling older adults in the population-based Singapore Longitudinal Aging Studies. No patients were diagnosed with end-stage kidney disease or used dialysis.
Researchers measured malnutrition risk at baseline using the Nutrition Screening Initiative Determine Your Nutritional Health Checklist and measured eGFR at baseline. At a follow-up of 3 to 5 years, researchers recorded eGFR again in a sub-cohort of participants without CKD.
Baseline cross-sectional analyses revealed low, medium and high levels of malnutrition correlated with decreasing eGFR coefficients of –1.5 mL/min/1.73 m², –3.3 mL/min/1.73 m² and –5 mL/min/1.73 m², respectively, and increasing CKD odds ratios of 1.81, 2.18, and 3.11, respectively, among older adults. Similarly, researchers found longitudinal analyses revealed all levels of malnutrition were associated with increased risk of eGFR greater than 0.25 decline.
“Our study suggests that among older persons in the community, the presence of mild to moderate CKD is associated with the manifestation of MR which precedes renal function decline or incident CKD,” Lu and colleagues wrote. “Further research and clinical attention should consider effective dietary interventions to modify MR and slow renal function decline.”
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