The nutritional status of patients starting specialized predialysis care

Objective: To examine the prevalence of and risk factors for malnutrition at the start of specialized predialysis care. Design: The present analysis was performed on cross-sectional data collected at inclusion in the study. The study included 25 outpatient clinics delivering specialized predialysis care in the Netherlands. Subjects: Three hundred seventy-six incident patients with advanced chronic kidney disease attending one of the participating outpatient clinics. Main Outcome Measure: Subjective global assessment (SGA) of nutritional status. Results: At the start of specialized predialysis care, 11% of patients suffer from moderate protein-energy wasting as measured by SGA. Independent risk factors are age >75years (Odds ratio [OR], 3.88 [1.74-8.66]), female gender (OR, 2.95 [1.37-6.32]), and having a body mass index 2 (OR, 2.56 [1.19-5.49]). Estimated glomerular filtration rate was not significantly associated with SGA (OR, 1.63 [0.76-3.48]). Conclusions: Eleven percent of patients started on specialized predialysis care suffer from moderate protein-energy wasting; risk factors are age >75years, female gender, and BMI 2.