Low Prevalence of Protein Energy Wasting in Advanced Chronic Kidney Disease Patients Managed with a Nutritional Monitoring Program
Guillermina Barril*, Angel Nogueira, Graciela Alvarez, Almudena Nuñez, Carmen Sanchez and Paula Romasco
Department of Nephrology, Hospital Universitario de la Princesa, Madrid, Spain
*Corresponding Author: Guillermina Barril, Department of Nephrology, Hospital Universitario de la Princesa, Madrid, Spain.
November 18, 2021; Published: December 14, 2021
Objectives: To analyze the prevalence of Protein Energy Wasting (PEW) in Advanced Chronic Kidney Patients (ACKD) using monitoring tools normally used in the multidisciplinary CKD Unit. To assess the differences in nutritional parameters, body composition and muscle strength between patients with and without PEW.
Design and Method: Retrospective cross sectional study of patients from the ACKD Unit. The study included outpatient consultations offering specialized care for ACKD in the multidisciplinary hospital unit. We performed an initial nutritional assessment with screening and a complete baseline assessment followed by screening at each consultation (minimum every 3 months) and complete assessment every 6 months or if malnutrition appeared in the screening of risk. We performed screening and complete evaluation with biochemical parameters, body composition assessed by vectorial-bioimpedance and anthropometry, and hand grip strength measurement. PEW was diagnosed according to international society of renal nutrition and metabolism (ISRNM) criteria.
Results: We found a PEW prevalence of 9.1% (29/320 patients) without significant differences between men and women. The mean age of the patients with PEW was higher than that of non-PEW patients (74.58 ± 12.84 vs 70.54 ± 12.37), although the difference was not statistically significant.
We observed significant differences in biochemical parameters, vectorial bioimpedance and anthropometric values, and hand grip strength between patients with and without PEW. A multivariate regression analysis showed that age, transferrin, % fat-free-mass, % total body water and phase-angle were predictive factors for PEW. Of them, phase angle was the best predictive factor.
Conclusions: The use of nutritional status monitoring protocols results in low prevalence of PEW and allows its early detection, thereby favoring the reversion of this condition with the appropriate intervention. An adequate nutritional status monitoring is a priority for the integral care of patients at ACKD Units.
Keywords: Advanced Chronic Kidney Disease Unit (ACKD); Protein Energy Wasting (PEW); Malnutrition; Inflammation
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