A high prevalence of abnormal nutrition parameters found in predialysis XXXX : is it a result of uremia or poor eating habits?

@entity1 @entity1501 @entity270 @entity28 @entity1009 @entity219 @entity8728 @entity560 @entity454
OBJECTIVE: To describe the baseline nutritional characteristics of a cohort of @entity454 ( @entity454 ) @entity1 attending a pre-dialysis clinic. SETTING: Outpatient clinic of a metropolitan tertiary teaching hospital in Sydney, Australia. SUBJECTS: All @entity454 @entity1 attending the multidisciplinary pre-dialysis assessment clinic between April 2002 and March  2008. METHODS: Retrospective analysis of data extracted from the routine initial nutrition assessment records. These included anthropometric and biochemical measures, Subjective Global Assessment, appetite score, presence of symptoms, dietary energy, protein, and other macro- and micronutrient intakes. RESULTS: Of the 210 @entity1 assessed, 60.5% were male; mean age was 65.7      13.6  years with a mean glomerular filtration rate of 17.3      6.5  mL/ @entity1009 .73  m(2); 17.1% and 62.4% were underweight (body mass index <23  kg/m(2)) and overweight or @entity28 (BMI >= 26  kg/m(2)), respectively; 40.5% were rated as malnourished (Subjective Global Assessment scores B and C) with 19.0% overweight/ @entity28 and malnourished. Energy and protein intakes correlated positively with glomerular filtration rate, with r  =  0.17, P = .01, and r  =  0.29, P  <  .0001 respectively. Mean energy and protein intakes were 23.7      6.7  kcal/kg IBW/day and 1.18      0.42  g/kg IBW/day, with 62.6% and 13.1% not meeting the recommended intake, respectively. The positive predictive values (95%CI) of self-rated appetite score for energy and protein were 0.41 (0.36-0.45) and 0.92 (0.88-0.95), respectively, indicating subjective rating of a good appetite was associated with adequate protein but not energy intake. Fifty-one percent of the @entity1 experienced the symptoms, whereas 17.5% of the @entity1 self-imposed a dietary regimen inappropriately due to beliefs on dietary needs in @entity454 . Suboptimal nutrient intakes were observed, including @entity8728 (41.2%), @entity270 (61.8%), @entity1501 (67.6.2%), @entity560 (100.0%), and @entity219 (64.2%). CONCLUSION: @entity1 presented to the pre-dialysis assessment clinic with abnormal nutrition parameters associated with decreased renal function, symptoms burden, and poor dietary intake. This clinic may provide an opportunity to optimize the nutritional status of @entity454 @entity1 in the pre-dialysis period.
