Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study.
Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = -0.33, p < 0.001) and those with lower glomerular filtration rate (r = 0.47, p < 0.001). The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61-15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.
['Kiuchi|Aki|A|', 'Ohashi|Yasushi|Y|', 'Tai|Reibin|R|', 'Aoki|Toshiyuki|T|', 'Mizuiri|Sonoo|S|', 'Ogura|Toyoko|T|', 'Aikawa|Atsushi|A|', 'Sakai|Ken|K|']
D000367:Age Factors D000368:Aged D015992:Body Mass Index D018753:Diet, Protein-Restricted D004044:Dietary Proteins D004435:Eating D005260:Female D005500:Follow-Up Studies D015577:Geriatric Assessment D006305:Health Status Indicators D006801:Humans D008297:Male D008875:Middle Aged D015596:Nutrition Assessment D009752:Nutritional Status D016016:Proportional Hazards Models D011507:Proteinuria D051436:Renal Insufficiency, Chronic D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D012709:Serum Albumin
geriatric nutritional risk index chronic kidney disease body mass index serum albumin nutritional status body composition food intake wasting syndrome