Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

• Published in: Nutrients 2016-10, Vol.8 (10), p.662-662
• Main Authors: Kiuchi, Aki, Ohashi, Yasushi, Tai, Reibin, Aoki, Toshiyuki, Mizuiri, Sonoo, Ogura, Toyoko, Aikawa, Atsushi, Sakai, Ken
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Blood pressure; Body composition; Body Mass Index; chronic kidney disease; Clinical outcomes; Cohort analysis; Diet, Protein-Restricted - adverse effects; Dietary Proteins; Eating; Energy; Female; Follow-Up Studies; food intake; Geriatric Assessment; geriatric nutritional risk index; Geriatrics; Health Status Indicators; Humans; Kidney diseases; Male; Malnutrition; Middle Aged; Mortality; Nephrology; Nutrients; Nutrition Assessment; Nutrition research; Nutritional Status; Proportional Hazards Models; Proteins; Proteinuria - etiology; Proteinuria - mortality; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - physiopathology; Retrospective Studies; Risk Assessment - methods; Risk Factors; serum albumin; Serum Albumin - analysis; wasting syndrome
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu8100662

Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients ( = -0.33, < 0.001) and those with lower glomerular filtration rate ( = 0.47, < 0.001). The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61-15.42, = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.