Department of Internal Medicine, Central Hospital, Benin City, Edo State, Nigeria.
Moonshine Elder Care Centre, Benin City, Edo State, Nigeria.
PLoS One. 2023 May 23;18(5):e0286075. doi: 10.1371/journal.pone.0286075. eCollection 2023.
Protein energy wasting (PEW) is common among chronic kidney disease (CKD) patients, especially those with advanced stage. It worsens frailty, sarcopenia and debility in CKD patients. Despite the importance of PEW, it is not routinely assessed during management of CKD patients in Nigeria. The prevalence of PEW and its associated factors were determined in pre-dialysis CKD patients.
This was a cross-sectional study that involved 250 pre-dialysis CKD patients and 125 age- and sex- matched healthy controls. Body mass index (BMI), subjective global assessment (SGA) scores and serum albumin levels were used in PEW assessment. The factors associated with PEW were identified. P-value of < 0.05 was taken as significant.
The mean age of CKD and control group were 52.3±16.0 years and 50.5±16.0 years, respectively. The prevalence of low BMI, hypoalbuminaemia and malnutrition defined by SGA in pre-dialysis CKD patients were 42.4%, 62.0% and 74.8%, respectively. The overall prevalence of PEW among the pre-dialysis CKD patients was 33.3%. On multiple logistic regression, the factors associated with PEW in CKD were being middle aged (adjusted odds ratio: 12.50; confidence interval: 3.42-45.00; p <0.001), depression (adjusted odds ratio: 2.34; confidence interval: 1.02-5.40; p = 0.046) and CKD stage 5 (adjusted odds ratio: 12.83; confidence interval: 3.53-46.60; p <0.001).
PEW is common in pre-dialysis CKD patients and it was associated with middle age, depression and advanced CKD. Early intervention aimed at addressing depression in early stages of CKD may prevent PEW and improve overall outcome in CKD patients.
蛋白质能量消耗（PEW）在慢性肾脏病（CKD）患者中很常见，尤其是在晚期患者中。它会加重 CKD 患者的虚弱、肌肉减少症和乏力。尽管 PEW 很重要，但在尼日利亚对 CKD 患者的管理中并未常规评估。本研究旨在确定透析前 CKD 患者中 PEW 的患病率及其相关因素。
这是一项横断面研究，共纳入 250 例透析前 CKD 患者和 125 名年龄和性别匹配的健康对照者。采用体质指数（BMI）、主观综合评估（SGA）评分和血清白蛋白水平评估 PEW。确定与 PEW 相关的因素。P 值<0.05 为有统计学意义。
CKD 组和对照组的平均年龄分别为 52.3±16.0 岁和 50.5±16.0 岁。透析前 CKD 患者中低 BMI、低白蛋白血症和 SGA 定义的营养不良的患病率分别为 42.4%、62.0%和 74.8%。透析前 CKD 患者中 PEW 的总体患病率为 33.3%。多因素 logistic 回归分析显示，CKD 患者发生 PEW 的相关因素为中年（调整后优势比：12.50；95%置信区间：3.42-45.00；p<0.001）、抑郁（调整后优势比：2.34；95%置信区间：1.02-5.40；p=0.046）和 CKD 5 期（调整后优势比：12.83；95%置信区间：3.53-46.60；p<0.001）。
透析前 CKD 患者中 PEW 很常见，与中年、抑郁和晚期 CKD 有关。在 CKD 早期阶段早期干预以解决抑郁问题可能会预防 PEW 并改善 CKD 患者的整体预后。
