Nutritional Status, Body Composition, and Inflammation Profile in Older Patients with Advanced Chronic Kidney Disease Stage 4-5: A Case-Control Study.

ABSTRACT

Nutritional status is a predictor of adverse outcomes and mortality in patients with advanced chronic kidney disease (ACKD). This study aimed to explore and evaluate risk factors related to nutritional status, body composition, and inflammatory profile in patients with ACKD compared with age- and sex-matched controls in a Mediterranean cohort of the Spanish population. Out of 200 volunteers recruited, 150 participants (64%) were included, and a case-control study was conducted on 75 ACKD patients (stages 4−5), matched individually with controls at a ratio of 11 for both age and sex. At enrolment, demographic, clinical, anthropometric, and laboratory parameters were measured. Bioimpedance analysis (BIA) was used to assess both body composition and hydration status. ACKD patients had lower body cell mass (BCM%), muscle mass (MM%) phase angle (PA), s-albumin, and higher C-reactive protein (s-CRP) than controls (at least, p < 0.05). PA correlated positively with BCM% (cases r = 0.84; controls r = 0.53, p < 0.001), MM% (cases r = 0.65; controls r = 0.31, p < 0.001), and inversely with s-CRP (cases r = −0.30, p < 0.001; controls r = −0.31, p = 0.40). By univariate and multivariate conditional regression analysis, total body water (OR 1.186), extracellular mass (OR 1.346), s-CRP (OR 2.050), MM% (OR 0.847), PA (OR 0.058), and s-albumin (OR 0.475) were significantly associated among cases to controls. Nutritional parameters and BIA-derived measures appear as prognostic entities in patients with stage 4−5 ACKD compared to matched controls in this Mediterranean cohort.