Combination of low body mass index and serum albumin level is associated with chronic kidney disease progression: the chronic kidney disease-research of outcomes in treatment and epidemiology (CKD-ROUTE) study

被引：32

作者：

Kikuchi, Hiroaki ^{[1
]}

Kanda, Eiichiro ^{[2
]}

Mandai, Shintaro ^{[1
]}

Akazawa, Masanobu ^{[3
]}

Iimori, Soichiro ^{[1
]}

Oi, Katsuyuki ^{[2
]}

Naito, Shotaro ^{[1
]}

Noda, Yumi ^{[6
]}

Toda, Takayuki ^{[4
]}

Tamura, Teiichi ^{[5
]}

Sasaki, Sei ^{[1
]}

Sohara, Eisei ^{[1
]}

Okado, Tomokazu ^{[1
]}

Rai, Tatemitsu ^{[1
]}

Uchida, Shinichi ^{[1
]}

机构：

[1] Tokyo Med & Dent Univ, Dept Nephrol, Tokyo, Japan

[2] Tokyo Kyosai Hosp, Dept Nephrol, Meguro Ku, 2-3-8 Nakameguro, Tokyo 1538934, Japan

[3] JA Toride Med Ctr, Dept Nephrol, Ibaraki, Japan

[4] Tsuchiura Kyodo Gen Hosp, Dept Nephrol, Ibaraki, Japan

[5] Yokosuka Kyosai Hosp, Dept Nephrol, Yokosuka, Kanagawa, Japan

[6] Nitobe Mem Nakano Gen Hosp, Dept Nephrol, Tokyo, Japan

来源：

CLINICAL AND EXPERIMENTAL NEPHROLOGY | 2017年 / 21卷 / 01期

关键词：

Albumin; Body mass index; Chronic kidney disease; Nutrition; Protein-energy wasting; RENAL-DISEASE; NUTRITIONAL-STATUS; RISK; PROTEIN; MORTALITY; PREDICTABILITY; MALNUTRITION; INFLAMMATION; BIOMARKERS; PREDICTOR;

D O I：

10.1007/s10157-016-1251-2

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background The relationship between protein-energy wasting and chronic kidney disease (CKD) progression is unknown. In the present prospective cohort study, we evaluated the hypothesis that a combination of low body mass index (BMI) and serum albumin level is associated with rapid CKD progression. Methods The study cohort comprised 728 predialysis Japanese patients with CKD (stages 2-5) enrolled from 2010 to 2011. Patients were categorized into four groups according to their serum albumin levels and BMI: group 1, low serum albumin level (<4 g/dL) and low BMI (<23.5 kg/m(2)); group 2, high serum albumin level (>= 4 g/dL) and low BMI; group 3, low serum albumin level and high BMI (>= 23.5 kg/m(2)); and group 4, high serum albumin level and high BMI. The primary outcome was a 30 % decline in estimated glomerular filtration rate (eGFR) or start of dialysis within 2 years. The secondary outcome was an annual GFR decline (mL/min/1.73 m(2)/year). Results Logistic regression analysis adjusted for baseline characteristics (reference, group 4) showed that only group 1 was associated with a significant risk of CKD progression, with adjusted odds ratio of 3.51 [95 % confidence interval (CI) (1.63, 7.56)]. A multivariate linear regression analysis adjusted for baseline characteristics showed a significant difference in annual eGFR decline between groups 1 and 4 [coefficients beta (standard error) -2.62 (0.75), p = 0.001]. Conclusion This study suggests that combined effects of low BMI (<23.5 kg/m(2)) and serum albumin level (<4 g/dL) are associated with CKD progression.

引用

页码：55 / 62

页数：8

共 32 条

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