{"title":"营养状况与新发慢性肾脏疾病。","authors":"Atsuya Sato, Kenichi Tanaka, Hiroshi Kimura, Hirotaka Saito, Michio Shimabukuro, Koichi Asahi, Tsuyoshi Watanabe, Junichiro James Kazama","doi":"10.1016/j.clnesp.2025.09.035","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Malnutrition is associated with adverse outcomes across various populations, but its role in the development of chronic kidney disease (CKD) remains unclear. Our study evaluated relationship between nutritional status and CKD development in patients with CKD risk factors.</p><p><strong>Methods: </strong>A total of 1,046 adults with one or more CKD risk factors, an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m<sup>2</sup>, and no proteinuria were examined to investigate the association between nutritional status and new-onset CKD using longitudinal data from the Fukushima Cohort Study. Nutritional status was assessed using the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Cox proportional hazards modeling was used to evaluate the association between nutritional status and CKD development. The predictive performance of each nutritional index was assessed using receiver operating characteristic curves.</p><p><strong>Results: </strong>During follow-up (median, 5.2 years), 325 participants developed CKD. Compared to the highest tertile, participants in the lowest tertile of the PNI showed a significantly increased risk of developing CKD (adjusted hazard ratio, 1.65; 95 % confidence interval, 1.21-2.24). Similar associations were observed for GNRI and CONUT scores in relation to CKD risk. Although the PNI showed a slightly higher AUC than the GNRI and CONUT score, the differences were small and not statistically significant.</p><p><strong>Conclusion: </strong>In this retrospective cohort study, poor nutritional status was associated with increased risk of CKD development in a high-risk population. Nutritional assessment using indices such as the PNI, GNRI, or CONUT score may help identify individuals at elevated risk for CKD, highlighting the potential role of nutritional interventions in CKD prevention. As all three indices showed comparable associations with CKD risk, each may be useful for risk stratification in clinical practice.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"274-280"},"PeriodicalIF":2.6000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nutritional status and new onset of chronic kidney disease.\",\"authors\":\"Atsuya Sato, Kenichi Tanaka, Hiroshi Kimura, Hirotaka Saito, Michio Shimabukuro, Koichi Asahi, Tsuyoshi Watanabe, Junichiro James Kazama\",\"doi\":\"10.1016/j.clnesp.2025.09.035\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Malnutrition is associated with adverse outcomes across various populations, but its role in the development of chronic kidney disease (CKD) remains unclear. Our study evaluated relationship between nutritional status and CKD development in patients with CKD risk factors.</p><p><strong>Methods: </strong>A total of 1,046 adults with one or more CKD risk factors, an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m<sup>2</sup>, and no proteinuria were examined to investigate the association between nutritional status and new-onset CKD using longitudinal data from the Fukushima Cohort Study. Nutritional status was assessed using the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Cox proportional hazards modeling was used to evaluate the association between nutritional status and CKD development. The predictive performance of each nutritional index was assessed using receiver operating characteristic curves.</p><p><strong>Results: </strong>During follow-up (median, 5.2 years), 325 participants developed CKD. Compared to the highest tertile, participants in the lowest tertile of the PNI showed a significantly increased risk of developing CKD (adjusted hazard ratio, 1.65; 95 % confidence interval, 1.21-2.24). Similar associations were observed for GNRI and CONUT scores in relation to CKD risk. Although the PNI showed a slightly higher AUC than the GNRI and CONUT score, the differences were small and not statistically significant.</p><p><strong>Conclusion: </strong>In this retrospective cohort study, poor nutritional status was associated with increased risk of CKD development in a high-risk population. Nutritional assessment using indices such as the PNI, GNRI, or CONUT score may help identify individuals at elevated risk for CKD, highlighting the potential role of nutritional interventions in CKD prevention. As all three indices showed comparable associations with CKD risk, each may be useful for risk stratification in clinical practice.</p>\",\"PeriodicalId\":10352,\"journal\":{\"name\":\"Clinical nutrition ESPEN\",\"volume\":\" \",\"pages\":\"274-280\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical nutrition ESPEN\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.clnesp.2025.09.035\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.clnesp.2025.09.035","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Nutritional status and new onset of chronic kidney disease.
Background and aims: Malnutrition is associated with adverse outcomes across various populations, but its role in the development of chronic kidney disease (CKD) remains unclear. Our study evaluated relationship between nutritional status and CKD development in patients with CKD risk factors.
Methods: A total of 1,046 adults with one or more CKD risk factors, an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, and no proteinuria were examined to investigate the association between nutritional status and new-onset CKD using longitudinal data from the Fukushima Cohort Study. Nutritional status was assessed using the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Cox proportional hazards modeling was used to evaluate the association between nutritional status and CKD development. The predictive performance of each nutritional index was assessed using receiver operating characteristic curves.
Results: During follow-up (median, 5.2 years), 325 participants developed CKD. Compared to the highest tertile, participants in the lowest tertile of the PNI showed a significantly increased risk of developing CKD (adjusted hazard ratio, 1.65; 95 % confidence interval, 1.21-2.24). Similar associations were observed for GNRI and CONUT scores in relation to CKD risk. Although the PNI showed a slightly higher AUC than the GNRI and CONUT score, the differences were small and not statistically significant.
Conclusion: In this retrospective cohort study, poor nutritional status was associated with increased risk of CKD development in a high-risk population. Nutritional assessment using indices such as the PNI, GNRI, or CONUT score may help identify individuals at elevated risk for CKD, highlighting the potential role of nutritional interventions in CKD prevention. As all three indices showed comparable associations with CKD risk, each may be useful for risk stratification in clinical practice.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
