Nutrition and kidney disease are inextricably linked, so it comes as no surprise that a new study all but confirms long-term dialysis success or failure is, in large part, determined by what kind of nutrition and lifestyle habits kidney disease patients espouse. A recent study showed about 35% of patients with advanced chronic kidney disease experienced a deterioration in nutritional status before their dialysis program. Researchers said they linked the changes to physical function, smoking and gastrointestinal symptoms to an increased risk.
Researchers looked at 1,103 patients with CKD stages 4 to 5 who had repeated measurements of the seven-point subjective global assessment (SGA). Researchers said the SGA is made of four parts. These are patients’ history of weight change, history of dietary intake and gastrointestinal symptoms, a physical examination with visual inspection to screen for loss of fat mass and muscle wasting. They said they defined a decline in nutritional status as at least one point during the first 12 months of follow-up. A severe decline was defined as a decline of two or more points during the first 12 months of follow-up.
Patients were at least 65 years and were from Germany, Italy, the Netherlands, Poland, Sweden or the UK. Twenty-eight percent were considered moderately malnourished at the baseline. Twenty-four percent began treatment with dialysis with a mean follow-up of 1.6 years.
During follow-ups one year later, researchers found impaired nutritional status in 34.9% of the study population, with a severe decline in SGA occurring in 10.9%. The entire follow-up period showed mean SGA change was -0.18 points per year. They also found patients with lower SGA scores increased every 6 months. The proportion of patients with SGA scores of 6 or 7 went down. Researchers found decline in SGA was associated with greater reduction in eGFR (mean change of 2 mL/min/1.73 m2 vs. -0.7 mL/min/1.73 m2 for those whose nutritional status remained stable throughout the study period).
Researchers found factors which could be modified. Smoking was found to be a very strong risk factor. Additionally, mental health could have a significant impact, as patients with stable mental health had a stable nutritional status. The opposite was found for patients who score low for mental health.
Researchers admitted the cause and effect of many relationships may be hard to figure out. They said other factors such as fatigue and lack of motivation might be contributing to poor diet and lack of motivations. They added deteriorated nutrition could hurt the mental health and effect health behavior. For more of the latest on kidney health, kidney studies and more be sure to tune in to our YouTube channel.
