Analysis of influencing factors on the nutritional status of non-dialysis elderly patients with chronic kidney disease and depression.

Background: The assessment of nutritional status in non-dialysis elderly patients with chronic kidney disease (CKD) and comorbid depression is clinically important. Determining key determinants of nutritional status in this population significantly improves nutritional management strategies and assists these patients overcome the disease.

Aim: To investigate the factors influencing the nutritional status of non-dialysis elderly patients with CKD and comorbid depression.

Methods: This study retrospectively collected the clinical data of 182 non-dialysis elderly patients with CKD and comorbid depression admitted at Tangdu Hospital, Air Force Medical University, from January 2022 to June 2023. The participants were categorized based on the presence of malnutrition into the nutritionally normal group (n = 97) and the malnutrition group (n = 85). The clinical data of the two groups were subjected to unifactorial and multifactorial regression to analyze the factors influencing malnutrition among the participants. Data included sex, age, body mass index (BMI), percentage body fat, basal metabolic rate (BMR), blood urea nitrogen (BUN), creatinine (Cr), albumin (Alb), hemoglobin (Hb), pre-albumin (PA), patient-generated subjective global assessment, and Patient Health Questionnaire-9 (PHQ-9) score to identify depressive symptoms. After admitting the patients to the hospital, 5 mL of peripheral serum was withdrawn, the centrifuge was operated at 3500 rpm/minute with a centrifugal radius of 10 cm for 10 minutes, serum was collected, and serum Alb, Hb, PA, BUN, and Cr levels were detected using a fully automatic biochemical analyzer. The results were assessed using Statistical Package for the Social Sciences version 21.0 for conducting technical analyses. Metric data are presented as the mean ± standard error of the mean and replaced using the t-test. Count data are expressed as case counts and percentages and were replaced using the χ ² test. Effective factors were modeled using logistic return modeling.

Results: BMI, BMR, and serum Alb, Hb, PA, and Cr levels were lower in the nutritionally normal group than in the malnutrition group. Furthermore, BUN levels, PHQ-9 scores, and the percentage of anxiety symptoms were greater in the nutritionally normal group than in the normal nutrition group, with statistically significant differences (P < 0.05). Multiple factorial interpretations revealed anxiety and serum Alb, Hb, and PA levels as factors influencing the nutritional status of non-dialysis elderly patients with CKD and depression (P < 0.05).

Conclusion: Serum Alb, Hb, PA levels, and anxiety symptoms are all factors influencing malnutrition in non-dialysis elderly patients with CKD and depression; hence, clinical interventions can be targeted to patients with the above characteristics.