Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.
PhD Program in Biomedicine, Department of Experimental and Health Sciences, Universitat Pompeu Fabra-Doctoral School, Barcelona, Spain.
JPEN J Parenter Enteral Nutr. 2023 Aug;47(6):802-811. doi: 10.1002/jpen.2532. Epub 2023 Jul 7.
Malnutrition is frequent in patients with chronic kidney disease (CKD) and has a negative impact on morbidity, mortality, and quality of life. The objective of this study was to assess the value of the Global Leadership Initiative for Malnutrition (GLIM) criteria to predict hospitalizations and mortality in candidates to kidney transplant during their first year on the waiting list.
This was a post hoc analysis of 368 patients with advanced CKD. The main study variables were malnutrition, according to the GLIM criteria; number of hospital admissions during the first year on the waiting list; and mortality at the end of follow-up. Kaplan-Meier survival curves and binary logistic regression were performed, adjusting for age, frailty status, handgrip strength, and Charlson Index as potential confounders.
The prevalence of malnutrition was 32.6%. Malnutrition was associated with increased risk of hospitalizations during the first year on the waiting list (odds ratio [OR] = 3.33 [95% CI = 1.34-8.26]), which persisted after adjustment for age and frailty status (adjusted OR = 3.61 [95% CI = 1.38-10.7]), age and handgrip strength (adjusted OR = 3.39 [95% CI = 1.3-8.85]), and age and Charlson Index (adjusted OR = 3.25 [95% CI = 1.29-8.13]).
Malnutrition according to the GLIM criteria was highly prevalent in patients with CKD and was associated with a threefold increased risk of hospitalizations during the first year on the waiting list; these associations remained significant after adjusting for age, frailty status, handgrip strength, and comorbidities.
慢性肾脏病（CKD）患者常发生营养不良，这对发病率、死亡率和生活质量有负面影响。本研究旨在评估全球肾脏病倡议营养不良（GLIM）标准对预测等待肾移植期间第一年住院和死亡率的价值。
这是一项对 368 名晚期 CKD 患者的事后分析。主要研究变量为根据 GLIM 标准评估的营养不良、等待名单期间第一年的住院次数和随访结束时的死亡率。进行 Kaplan-Meier 生存曲线和二项逻辑回归分析，调整年龄、虚弱状态、握力和 Charlson 指数作为潜在混杂因素。
营养不良的患病率为 32.6%。营养不良与等待名单第一年住院风险增加相关（优势比 [OR] = 3.33 [95% CI = 1.34-8.26]），调整年龄和虚弱状态后仍持续存在（调整 OR = 3.61 [95% CI = 1.38-10.7]），调整年龄和握力（调整 OR = 3.39 [95% CI = 1.3-8.85]）和年龄和 Charlson 指数（调整 OR = 3.25 [95% CI = 1.29-8.13]）。
根据 GLIM 标准评估的 CKD 患者营养不良的患病率很高，与等待名单第一年住院风险增加三倍相关；这些关联在调整年龄、虚弱状态、握力和合并症后仍然显著。
