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ABSTRACT
Objective. This cross-sectional study was designed to evaluate the nutritional status of non-dialyzed chronic kidney disease (CKD) patients and to identify predictive factors of malnutrition in this population. Methods. Consenting non-dialyzed CKD patients aged above 21 years who consulted at the out-patient nephrology unit of the Yaounde General Hospital (YGH), from December 2013 to March 2014 were eligible. Patients with acute intercurrent illnesses, malignancy, or prosthetic devices were excluded. Relevant clinical data was recorded. Laboratory, anthropometric and bioelectric impedance parameters of interest were evaluated. Nutritional status was assessed using the Subjective Global Assessment (SGA) questionnaire. Multivariate regression analysis was used to determine predictors of malnutrition. Results. A total of 72 (42 males) were included in the study. Their mean (standard deviation) age was 56.22 (11.80) years. The median (interquartile range, IQR) estimated glomerular filtration rate (eGFR) was 17.00 (10.50 – 30.50) ml/min/1.73 m2, with 41.7% of patients in CKD stage 5. The most frequent etiologies of CKD were hypertension (30.6%) and diabetes (23.6%). The median (IQR) protein intake was 1.02 (0.71 – 1.35) g/kg/day. The prevalence (95% confidence interval) of malnutrition was 38.9 % (27.3% – 50.0%). In multiple regression analysis, only low eGFR was an independent predictor of malnutrition. Bioimpedance and anthropometric parameters were not predictive of malnutrition. Conclusion. Malnutrition was common in CKD patients. A low eGFR was an independent predictor of malnutrition. These findings highlight the importance of nutritional assessment and intervention in the care of non-dialyzed CKD populations especially those with stage 5 CKD.
RÉSUMÉ
Objectif. Evaluer l'état nutritionnel des patients atteints de maladie rénale chronique (MRC) non dialysés et identifier les facteurs prédictifs de malnutrition dans cette population. Méthodologie. Etude transversale portant sur des patients atteints de MRC non dialysés, âgés de plus de 21 ans suivis à l'Hôpital Général de Yaoundé (HGY) de décembre 2013 à mars 2014. Des données cliniques, biologiques, anthropométriques et de la bioimpédance étaient recueillies. L'état nutritionnel a été évalué à l'aide du questionnaire "Subjective Global Assessment" (SGA). L'analyse multivariée était utilisée pour déterminer les facteurs prédictifs de la malnutrition. Résultats. Nous avons recruté 72 patients (42 hommes) avec un âge moyen de 56,22 ± 11,80 ans. Le débit de filtration glomérulaire estimé (DFGe) médian (intervalle interquartile, IIQ) était de 17,00 (10,50 - 30,50) ml/min/1,73 m2, avec 41,7 % des patients au stade 5 de la MRC. Les étiologies les plus fréquentes de la MRC étaient l'hypertension (30,6 %) et le diabète (23,6 %). L'apport protidique médian (IIQ) était de 1,02 (0,71 - 1,35) g/kg/jour. La prévalence (intervalle de confiance à 95 %) de la malnutrition était de 38,9 % (27,3 % - 50,0 %). En analyse multivariée, seul un DFGe bas ressortait comme facteur prédictif indépendant de la malnutrition. Il n’y avait pas d'association entre les paramètres anthropométriques, de bioimpédance et la malnutrition. Conclusion. La malnutrition est fréquente chez les patients atteints de MRC. Le DFGe bas est le facteur prédictif indépendant de la malnutrition. Ces résultats témoignent de l'importance de l'évaluation et de la prise en charge nutritionnelle des patients atteints de MRC en particulier au stades 5.

Keywords

Malnutrition Non-dialyzed CKD SGA Predictive factors Sub-Saharan Africa. Malnutrition MRC non dialysée SGA facteurs prédictifs Afrique sub-saharienne.

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Nsounfon Abdou Wouoliyou, Ashuntantang Gloria, Maimouna Mahamat, Nguefack-Tsague Georges, Kaze Folefack François, & Ndjitoyap Ndam Elie-Claude. (2022). Prevalence and Predictors of Malnutrition in Patients with Chronic Kidney Disease Stages 3 – 5 non Dialyzed: Malnutrition in patients with chronic kidney disease. HEALTH SCIENCES AND DISEASE, 23(6). https://doi.org/10.5281/hsd.v23i6.3674
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