Nutritional disorders and survival rate of elderly and geriatric patients with CKD 3B-5 stage

Nephrology (Saint-Petersburg) Pub Date : 2024-07-15 DOI:10.36485/1561-6274-2024-28-2-63-68

E. G. Zaripova, A. I. Almukhametova, A. Maksudova

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Abstract

BACKGROUND. The prevalence of CKD in the population of the elderly and geriatric patients is varies from 23.4% to 35.8%. Nutritional status was recognized as an important factor of CKD prognosis. One of the factors affecting their survival is nutritional status. There have not been many studies on the effect of eating disorders on the survival of elderly and senile patients with CKD.THE AIM: to assess the impact of nutritional status on the survival of elderly patients with CKD stages 3b-5.PATIENTS AND METHODS. We’ve studied 190 people with CKD stages 3b-5 (eGFR<45 ml/min/m2) with an average age of 76 [67;86]. Exclusion criteria’s: dialysis, acute cardiovascular disorders, oncology, and psychiatric disorders. Nutritional status was assessed by Subjective Global Assessment scale, the 5-year risk of the death was evaluated absolute by the Bansal scale. The duration of study - 36 month.RESULTS. In the group of elderly and geriatric patients with CKD stages 3b-5, normal nutritional status was determined in 40.1% of patients, mild to moderate malnutrition in 54.7%, and protein-energy wasting (PEW) in 5.2%; up to 2.8% of patients were underweight. The best 3-year survival rate was observed in patients with normal nutritional status, mild nutritional status disorders and obesity, the worst survival rate - in patients with PEW and underweight (p<0,001). In the group of patients with CKD stage 4 the average Bansal score scale was 8 points, which corresponds to 69% of the absolute risk of death within 5 years; in patients with CKD stage 5, the average score was also 8 [7, 8]. CONCLUSION. In the group of elderly and geriatric patients with CKD stage 3b-5 and PEW survival rate was significantly lower than in patients without nutritional disorders and mild nutritional disorders; we didn’t find correlation between the estimated absolute risk of death according to the Bansal scale and actual survival in 3-year observation period.

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营养失调与 CKD 3B-5 期老年患者的存活率

背景。在老年人群和老年病患者中，慢性肾功能衰竭的发病率从 23.4% 到 35.8% 不等。营养状况被认为是影响慢性肾功能衰竭预后的一个重要因素。营养状况是影响患者生存的因素之一。关于饮食失调对老年和高龄 CKD 患者生存的影响的研究并不多。目的：评估营养状况对 CKD 3b-5 期老年患者生存的影响。患者和方法：我们研究了 190 名 CKD 3b-5 期患者（eGFR<45 ml/min/m2），平均年龄为 76 岁 [67;86]。排除标准：透析、急性心血管疾病、肿瘤和精神疾病。营养状况通过主观全面评估量表进行评估，5 年死亡风险通过班萨尔量表进行绝对评估。研究持续时间为 36 个月。在患有慢性肾功能衰竭 3b-5 期的老年患者组中，40.1% 的患者营养状况正常，54.7% 的患者轻度至中度营养不良，5.2% 的患者蛋白质能量消耗（PEW）；体重不足的患者高达 2.8%。营养状况正常、轻度营养失调和肥胖患者的 3 年存活率最高，蛋白能量消耗过多和体重不足患者的 3 年存活率最低（P<0.001）。在 CKD 4 期患者组中，Bansal 评分表的平均分是 8 分，相当于 5 年内死亡绝对风险的 69%；在 CKD 5 期患者中，平均分也是 8 分[7,8]。结论。在患有 CKD 3b-5 期和 PEW 的老年患者组中，存活率明显低于无营养障碍和轻度营养障碍的患者；我们没有发现根据 Bansal 量表估算的死亡绝对风险与 3 年观察期内的实际存活率之间存在相关性。

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Nephrology (Saint-Petersburg)

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