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Accepted manuscript

Cross-sectional Relationship Between Dietary Protein Intake, Energy Intake and Protein Energy Wasting in Chronic Kidney Disease Patients

Published online by Cambridge University Press:  31 May 2024

Qianqian Han
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Rui Zhang
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Jianping Wu
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Fengyi He
Affiliation:
Department of Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Fengchu Qin
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Wenlu Li
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Chaogang Chen*
Affiliation:
Department of Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
Qiongqiong Yang*
Affiliation:
Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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Abstract

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The potential threshold for dietary energy intake (DEI) that might prevent protein-energy wasting (PEW) in chronic kidney disease (CKD) is uncertain. The subjects were non-dialysis CKD patients aged ≥ 14 years who were hospitalized from September 2019 to July 2022. PEW was measured by subjective global assessment (SGA). DEI and dietary protein intake (DPI) were obtained by 3-days diet recalls. Patients were divided into adequate DEI group and inadequate DEI group according to DEI ≥ 30 or < 30 kcal/kg/d. Logistic regression analysis and restricted cubic spline (RCS) were used in this study. We enrolled 409 patients, with 53.8% had hypertension and 18.6% had diabetes. The DEI and DPI was 27.63 ± 5.79 kcal/kg/day and 1.00 (0.90,1.20) g/kg/day, respectively. 69.2% of participants in inadequate DEI group. Malnutrition occurred in 18.6% of patients. Comparing to patients in adequate DEI group, those in inadequate DEI group had significantly lower total lymphocyte count (TLC), serum cholesterol (Chol) and low-density cholesterol (LDL), and a higher prevalence of PEW. For every 1kcal/kg/day increase in DEI, the incidence of PEW was reduced by 12.0% [odds ratio (OR): 0.880, 95% confidence interval (CI): 0.830 to 0.933, P < 0.001]. There was a nonlinear curve relationship between DEI and PEW (overall P < 0.001), and DEI ≥ 27.6 kcal/kg/d may have a preventive effect on PEW in CKD. Low DPI was also significantly associated with malnutrition, but not when DEI was adequate. Decreased energy intake may be a more important factor of PEW in CKD than protein intake.

Type
Research Article
Copyright
© The Authors 2024

Footnotes

*

Qianqian Han and Rui Zhang contributed equally to this work.