title: Total kidney and liver volume is a major risk factor for malnutrition in ambulatory patients with autosomal dominant polycystic kidney disease.
abstract: In patients with autosomal dominant polycystic kidney disease (ADPKD), malnutrition may develop as renal function declines and the abdominal organs become enlarged. We investigated the relationship of intra-abdominal mass with nutritional status.
  
  
  
  This cross-sectional study was performed at a tertiary hospital outpatient clinic. Anthropometric and laboratory data including serum creatinine, albumin, and cholesterol were collected, and kidney and liver volumes were measured. Total kidney and liver volume was defined as the sum of the kidney and liver volumes and adjusted by height (htTKLV). Nutritional status was evaluated by using modified subjective global assessment (SGA).
  
  
  
  In a total of 288 patients (47.9% female), the mean age was 48.3 ± 12.2 years and the mean estimated glomerular filtration rate (eGFR) was 65.3 ± 25.3 mL/min/1.73 m2. Of these patients, 21 (7.3%) were mildly to moderately malnourished (SGA score of 4 and 5) and 63 (21.7%) were at risk of malnutrition (SGA score of 6). Overall, patients with or at risk of malnutrition were older, had a lower body mass index, lower hemoglobin levels, and poorer renal function compared to the well-nourished group. However, statistically significant differences in these parameters were not observed in female patients, except for eGFR. In contrast, a higher htTKLV correlated with a lower SGA score, even in subjects with an eGFR ≥45 mL/min/1.73 m2. Subjects with an htTKLV ≥2340 mL/m showed an 8.7-fold higher risk of malnutrition, after adjusting for age, hemoglobin, and eGFR.
  
  
  
  Nutritional risk was detected in 30% of ambulatory ADPKD patients with relatively good renal function. Intra-abdominal organomegaly was related to nutritional status independently from renal function deterioration.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea.
authors.forename: Hyunjin
authors.initials: H
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hyosang
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Hayne Cho
authors.initials: HC
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea.
authors.forename: Hyunsuk
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea.
authors.forename: Kyu-Beck
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gil Medical Center, Gacheon University, Incheon, Korea.
authors.forename: Wookyung
authors.initials: W
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea.
authors.forename: Kook-Hwan
authors.initials: KH
authors.lastname: Oh
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Eulji General Hospital, Seoul, Korea. nephro.hwang@gmail.com.
authors.forename: Young-Hwan
authors.identifier: 0000-0001-8935-2659
authors.initials: YH
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea. curie@snu.ac.kr.
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001827:Body Height; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D012709:Serum Albumin; D002784:Cholesterol; D003404:Creatinine
keywords: Autosomal-dominant polycystic kidney disease; Chronic kidney disease; Gender; Malnutrition; Polycystic liver disease