Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Critical Care Medicine, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu 611137, China.
Department of Internal Medicine, Traditional Chinese Medicine Hospital of Wenjiang District, Chengdu 611130, China.
Int J Clin Pract. 2023 Sep 26;2023:9910718. doi: 10.1155/2023/9910718. eCollection 2023.
Acute kidney injury (AKI) is a complex clinical syndrome of hospitalization that may be affected by undernutrition and metabolic changes. The aim of this meta-analysis was to systematically assess the association between malnutrition and the risk of prevalent AKI.
We searched PubMed, Embase, Ovid MEDLINE, Web of Science, and Chinese databases (WANFANG, VIP, and CKI) from database inception until May 1, 2023, for studies evaluating the association of malnutrition with the risk of AKI. Summary odds ratios (ORs) were estimated using a random-effects model.
We identified 17 observational studies, which included 273,315 individuals. Compared with patients with normal nutritional status, those with malnutrition had a 125% increased risk of prevalent AKI (pooled ORs, 2.25; 95% confidence interval, 1.80-2.82). Malnutrition was also significantly associated with prevalent AKI across all subgroups when subgroup analyses were performed on covariates such as region, study design, age, sample size, malnutrition assessment method, patient characteristics, covariate adjustment degree, and risk of bias. Meta-regression models demonstrated no significant differences in AKI risk between patients with malnutrition and without malnutrition.
Our results suggest that malnutrition may be a potential target for AKI prevention. However, well-designed studies with ethnically or geographically diverse populations are needed to evaluate strategies and interventions to prevent or slow the development and progression of AKI in malnourished individuals.
急性肾损伤（AKI）是一种住院期间的复杂临床综合征，可能受到营养不良和代谢变化的影响。本荟萃分析旨在系统评估营养不良与 AKI 发病风险之间的关系。
我们检索了 PubMed、Embase、Ovid MEDLINE、Web of Science 和中国数据库（万方、维普和中国知网），从数据库建立到 2023 年 5 月 1 日，以评估营养不良与 AKI 风险之间关系的研究。使用随机效应模型估计汇总优势比（OR）。
我们确定了 17 项观察性研究，共纳入 273315 名个体。与营养状况正常的患者相比，营养不良患者发生 AKI 的风险增加了 125%（汇总 OR，2.25；95%置信区间，1.80-2.82）。当根据地域、研究设计、年龄、样本量、营养不良评估方法、患者特征、协变量调整程度和偏倚风险等协变量进行亚组分析时，营养不良与 AKI 发病风险也显著相关。Meta 回归模型表明，营养不良患者与无营养不良患者的 AKI 风险无显著差异。
我们的研究结果表明，营养不良可能是 AKI 预防的一个潜在目标。然而，需要设计良好的、具有不同种族或地域人群的研究，以评估预防或减缓营养不良个体 AKI 发展和进展的策略和干预措施。
