title: Renal function associates with energy intake in elderly community-dwelling men.
abstract: Energy intake and renal function decrease with age. In patients with chronic kidney disease (CKD), spontaneous food intake decreases in parallel with the loss of renal function. The objective of the present study was to evaluate a possible relationship between renal dysfunction and energy intake in elderly community-dwelling men. A cross-sectional study including 1087 men aged 70 years from the Uppsala Longitudinal Study of Adult Men (ULSAM) community-based cohort was carried out. Dietary intake was assessed using 7 d food records, and glomerular filtration rate was estimated from serum cystatin C concentrations. Energy intake was normalised by ideal body weight, and macronutrient intake was energy-adjusted. The median normalised daily energy intake was 105 (interquartile range 88-124) kJ, and directly correlated with estimated glomerular filtration rate (eGFR) as determined by univariate analysis. Across the decreasing quartiles of eGFR, a significant trend of decreasing normalised energy intake was observed (P = 0·01). A multivariable regression model including lifestyle factors and co-morbidities was used for predicting total energy intake. In this model, regular physical activity (standardised β = 0·160; P = 0·008), smoking (standardised β = -0·081; P = 0·008), hypertension (standardised β = -0·097; P = 0·002), hyperlipidaemia (standardised β = -0·064; P = 0·037) and eGFR (per sd increase, standardised β = 0·064; P = 0·04) were found to be independent predictors of energy intake. Individuals with manifest CKD (eGFR < 60 ml/min per 1·73 m²) were more likely to have lower energy intake than those without. In conclusion, there was a direct and independent correlation between renal function and energy intake in a population-based cohort of elderly men. We speculate on a possible link between renal dysfunction and malnutrition in the elderly.
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, K56, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden.
authors.forename: Desiree
authors.initials: D
authors.lastname: Luis
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, K56, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Sjögren
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.affiliation: Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Ärnlöv
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, K56, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.affiliation: Department of Public Health and Caring Sciences,Clinical Nutrition and Metabolism, Uppsala University,Uppsala,Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, K56, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden.
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
mesh_terms: D000368:Aged; D000375:Aging; D000855:Anorexia / Q000209:etiology / Q000503:physiopathology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D004032:Diet / Q000009:adverse effects*; D015930:Diet Records; D018450:Disease Progression; D002149:Energy Intake; D005247:Feeding Behavior; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D051437:Renal Insufficiency / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C