Association between kidney function, nutritional status and anthropometric measures in older people

BMC Geriatrics

Małgorzata Pigłowska¹  Agnieszka Guligowska¹  Tomasz Kostka¹  Gerhard Wirnsberger²  Regina Roller-Wirnsberger²  Cornel Sieber³  Ellen Freiberger³  Axel C. Carlsson⁴  Johan Ärnlöv⁵  Sara Laínez Martínez⁶  Pedro Gil Gregorio⁶  Rafael Moreno-Gonzalez⁷  Francesc Formiga⁷  Fabrizia Lattanzio⁸  Andrea Corsonello⁹  Paolo Fabbietti^1,10  Ilan Yehoshua^1,11  Francesco Mattace-Raso^1,12  Lisanne Tap^1,12  Rada Artzi-Medvedik^1,13 

[1] Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Łódź, Poland;Department of Internal Medicine, Medical University of Graz, Graz, Austria;Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging, Krankenhaus Barmherzige Brüder, Friedrich-Alexander Universität Erlangen-Nürnberg, Koberger Strasse 60, 90408, Nuremberg, Germany;Department of Medical Sciences, Uppsala University, Uppsala, Sweden;Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden;Department of Medical Sciences, Uppsala University, Uppsala, Sweden;School of Health and Social Studies, Dalarna University, Falun, Sweden;Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden;Geriatric Department, Hospital Clínico San Carlos, Madrid, Spain;Geriatric Unit, Internal Medicine Department, Bellvitge University Hospital – IDIBELL – L’Hospitalet de Llobregat, Barcelona, Spain;Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy;Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy;Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124, Ancona, Italy;Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124, Ancona, Italy;Maccabi Healthcare Services Southern Region, Tel Aviv-Yafo, Israel;Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;The Recanati School for Community Health Professions at the Faculty of Health Sciences at Ben-Gurion University of the Negev, Beer-sheva, Israel;

关键词: Aging;    Chronic kidney disease;    MNA;    Malnutrition;    Undernutrition;    Overweight;    Obesity;   

DOI  :  10.1186/s12877-020-01699-1

来源: Springer

【 摘 要 】

BackgroundDifferent mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD.MethodsIn the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation.ResultsWe studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL).ConclusionThe population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.

【 授权许可】

CC BY