title: Nutritional Status in Adults with Predialysis Chronic Kidney Disease: KNOW-CKD Study.
abstract: Adverse changes in nutrition are prevalent and are strong indicators of adverse outcomes in patients with chronic kidney disease (CKD). The International Society of Renal Nutrition and Metabolism (ISRNM) proposed a common nomenclature and diagnostic criteria to identify protein-energy wasting (PEW) in CKD patients. We examined the nutritional status in 1,834 adults with predialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD) study. As there was a need for further understanding of nutritional status and associated factors in CKD, we evaluated the prevalence and associated factors of PEW in adults with predialysis CKD. The prevalence of PEW was about 9.0% according to ISRNM criteria and tended to increase with advanced stage in predialysis CKD. Those who concurrently had PEW, inflammation, and CVD were a small proportion (0.4%). In multivariate logistic regression model, PEW was independently associated with estimated glomerular filtration rate (eGFR) (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96-0.99), total CO₂ (OR, 0.93; 95% CI, 0.87-0.99), physical activity (OR, 0.43; 95% CI, 0.26-0.69), comorbid diabetes (OR, 1.68; 95% CI, 1.09-2.59), and high sensitivity C-reactive protein (hs-CRP) (OR, 1.03; 95% CI, 1.01-1.06). Our study suggests that PEW increases with advanced CKD stage. PEW is independently associated with renal function, low total CO₂, low physical activity, comorbid diabetes, and increased hs-CRP in adults with predialysis CKD.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Youl
authors.identifier: http://orcid.org/0000-0002-4204-9908
authors.initials: YY
authors.lastname: Hyun
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. kyubeck.lee@samsung.com.
authors.forename: Kyu Beck
authors.identifier: http://orcid.org/0000-0002-3904-5404
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Hyeok
authors.identifier: http://orcid.org/0000-0001-7923-5635
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Inje University Pusan Paik Hospital, Busan, Korea.
authors.forename: Yeong Hoon
authors.identifier: http://orcid.org/0000-0002-4101-9993
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea, Seoul St Mary's Hospital, Seoul, Korea.
authors.forename: Yong Soo
authors.identifier: http://orcid.org/0000-0003-2152-1289
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.
authors.forename: Sung Woo
authors.identifier: http://orcid.org/0000-0002-4419-3938
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yun Kyu
authors.identifier: http://orcid.org/0000-0001-8632-5743
authors.initials: YK
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Wan
authors.identifier: http://orcid.org/0000-0001-9401-892X
authors.initials: DW
authors.lastname: Chae
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Curie
authors.identifier: http://orcid.org/0000-0001-7033-1102
authors.initials: C
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D015995:Prevalence; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000473:pathology*; D056910:Republic of Korea; D012720:Severity of Illness Index; D019282:Wasting Syndrome / Q000150:complications / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein
keywords: Chronic Kidney Disease; Inflammation; Nutrition; Protein-Energy Wasting