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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Late referral for chronic kidney disease patients: nutritional point of view

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Author(s):
Guerra, Daiane Cristina [1] ; Neto Angeloco, Larissa Rodrigues [1] ; Furtado, Wander R. [1] ; Coelho, Eduardo Barbosa [1] ; Chiarello, Paula Garcia [1]
Total Authors: 5
Affiliation:
[1] Univ Sao Paulo, Med Sch Ribeirao Preto, BR-05508 Sao Paulo - Brazil
Total Affiliations: 1
Document type: Journal article
Source: NUTRICION HOSPITALARIA; v. 31, n. 3, p. 1286-1293, MAR 2015.
Web of Science Citations: 3
Abstract

The prevalence of late referral of patients with chronic kidney disease (CKD) is high and has been associated with a worse CKD prognosis, however few studies have been conducted from a nutritional perspective. Objective: Characterize the nutritional status of patients with CKD at first attendance in a nephrology service, with early (ER) and late referral (LR). Methodology: It was a cross-sectional study with patients older than 18 years referred to the Nephrology service of a University Hospital. The referral groups were classified according to estimated glomerular filtration rate (eGFR) as: LR (eGFR<15mL/min/1.73m2) or ER (eGFR>15 ml/min/1.73m2) based on the Kidney Disease Outcomes Quality Initiative. Nutritional evaluation included subjective global assessment (SGA), anthropometric, laboratory and bioelectrical impedance data. The SAS (R) software was used for statistical analysis. Results: Seventy-five patients were evaluated, 29% of them belonging to the LR group. This group showed a greater previous weight loss (-7.0 +/- 3.5 versus -2.8 +/- 7.0 Kg) and lower values for all anthropometric and body composition variables. In general, the laboratory results of the LR group also were worse. According to the SGA, all LR patients had some degree of malnutrition (50% with severe malnutrition against 28.8% in ER), showing significantly lower results for GFR (21.4 + 12.2 ml/min/1.73 m2), albumin (3.9 + 0.3 g/dL), serum bicarbonate (22.8 + 5.1 mmol/L) and phase angle (5.3+ 0.6 theta). Renal function was positively correlated with percent adequacy of arm circumference (r=0,40; p<0,01) and albumin (r=0,45; p<0,01). Conclusion: The LR group showed a worse nutritional status showing that, for the nutritional point of view, the delayed referral brings substantial losses that can make difference in future treatment, thus demonstrating the importance of early nutritional monitoring for this population. (AU)

FAPESP's process: 10/11179-3 - Nutritional and epidemiological profile of patients with chronic kidney disease of an university hospital screening
Grantee:Paula Garcia Chiarello
Support Opportunities: Regular Research Grants