Factors associated with malnutrition in elderly individuals with chronic kidney disease in conservative treatment

Authors

  • Melina Gabriela Monteiro Universidade Federal de Juiz de Fora https://orcid.org/0000-0003-1996-7871
  • Priscila Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. https://orcid.org/0000-0002-7983-6307
  • Íris Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
  • Cássia Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. https://orcid.org/0000-0003-1280-2601
  • Marcus Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. https://orcid.org/0000-0003-3651-9923
  • Ana Paula Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

DOI:

https://doi.org/10.34019/1982-8047.2020.v46.31466

Keywords:

Malnutrition, Elderly, Smoking, Chronic kidney failure, Conservative treatment

Abstract

Introduction: Malnutrition is present in the elderly with chronic kidney disease (CKD) under conservative treatment. It is one of the main factors that adversely affect the prognosis and is associated with increased morbidity and mortality. Objective: To evaluate the presence of malnutrition and associated factors in elderly people with CKD undergoing conservative treatment. Material and methods: Epidemiological study, with cross-sectional design, including patients with CKD stages 3,4 and 5, under conservative treatment, aged over 60 years. Socioeconomic, clinical, physical activity and anthropometric data were collected. Categorical variables were presented with absolute and relative frequencies and compared, according to sex, using Pearson's chi-square test. For the assessment of factors related to the presence of malnutrition, the BMI was dichotomized into malnourished and non-malnourished and the Odds ratio was calculated. Results: 136 individuals were evaluated. The prevalence of malnutrition was 13%, according to BMI, and mass depletion was found in 35.2% of women and 30% of men by the lean tissue index. It was found that the smoker is 7.36 times more likely to have malnutrition when compared to a non-smoker. Conclusion: A high prevalence of malnutrition was observed in this study. No associations were found with sex, schooling, income, sedentary lifestyle, CKD stage, DM and SAH. Smoking was the factor that showed a significant association with malnutrition.

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Author Biographies

Priscila, Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

Graduated in Nutrition (Federal University of Juiz de Fora - UFJF), specialization in Public Health (Centro Universitário Internacional - UNINTER), specialization in Multidisciplinary Nephrology (Federal University of Maranhão - UFMA) and master's in Public Health (UFJF). She acted as a substitute professor in the Nutrition department at UFJF, teaching the subjects: Nutritional assessment II, Nutrition of adults and the elderly, orientation of clinical internship and course completion works. He was a nutritionist for the HIPERDIA program, at the Minas Gerais Institute of Teaching and Research in Nephrology (IMEPEN) and at the Inter-municipal Cooperation Agency in Health Pé da Serra (ACISPES). In addition, he has professional experience as a nutritionist in residences for the elderly, in food and nutrition units (working in the worker's food program - PAT) and at the Santa Casa de Misericórdia Hospital in Juiz de Fora. Currently, she is a doctoral student in Public Health (UFJF) and a member of the Research Group on Nutrition and Public Health (GPENSC). He has experience in the area of ​​nutrition and public health, with an emphasis on nutritional analysis of populations, working mainly on the following topics: eating disorders, nutrition at maturity, chronic non-communicable diseases (with an emphasis on diabetes, arterial hypertension and chronic kidney disease), anthropometry , body composition and food environment.

Íris, Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

Currently, I work as a clinical nutritionist at Unimed Vertente do Caparaó. Master in Public Health (2019) from the Faculty of Medicine of the Federal University of Juiz Fora. Specialization in Public Health (2018) by the International University Center (UNINTER). Graduated in Nutrition (2016) from the Federal University of Juiz de Fora. At present, she is a member of the research group: "Research Group on Nutrition and Public Health" (GPENSC) and Reviewer at HU REVISTA. He has experience in Nutrition and Public Health with an emphasis on chronic diseases: Diabetes Mellitus and Chronic Kidney Disease. Performance in a project to monitor chronic non-communicable diseases in the city of Juiz de Fora.

Marcus, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

Graduated from the Federal University of Juiz de Fora (1974), master's degree in Medical Sciences from the State University of Rio de Janeiro (1979) and doctorate in Medicine (Nephrology) from the Federal University of São Paulo (1985). He is currently a professor at the Faculty of Medical and Health Sciences of Juiz de Fora and professor at the Ubaense Faculty Ozanam Coelho. Has experience in Medicine, with emphasis on Nephrology, acting on the following subjects: chronic kidney disease, chronic kidney disease, chronic renal failure, peritoneal dialysis and ultrasound.

Ana Paula, Department of Nutrition, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

Graduated in Nutrition from the Federal University of Ouro Preto (1997), master's degree in Biological Sciences from the Federal University of Ouro Preto (2004) and doctorate in Biological Sciences from the Federal University of Ouro Preto (2009). He is currently an associate professor at the Federal University of Juiz de Fora. He has experience in the area of Nutrition, with an emphasis on Nutrition and Public Health, acting mainly on the following themes: non-communicable diseases, nutritional epidemiology, children and adolescents.

References

Marinho AWGB, Penha AP, Silva MT, Galvão TF. Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura. Cad Saúde Colet. 2017; 25(3):379-88.

Oliveira CMC, Kubrusly M, Mota RS, Silva CAB, Oliveira VN. Desnutrição na insuficiência renal crônica: qual o melhor método diagnóstico na prática clínica. Bras Nefrol. 2010; 32(1):57-70.

Stenvinkel P, Heimbürger O, Paultre F, Diczfalusy U, Wang T, Berglund L et al. Strong association between malnutrition, inflammation, and atherosclerosis in chronic Renal failure. Kidney Int. 1999; 55:1899-911.

Berbel MN, Pinto MPR, Ponce D, Balbi AL. Aspectos nutricionais na lesão renal aguda. Rev Assoc Med Bras. 2011; 57(5):600-6.

Souza VA, Oliveira D, Mansur HN, Fernandes NMS, Bastos MG. Sarcopenia na doença renal crônica. J Bras Nefrol. 2015; 37(1):98-105.

Instituto Brasileiro de Geografia e Estatística (BR). Censo Demográfico 2010 [Internet]. 2010 [citado em ano mês dia]. Disponível em: http://www.censo2010.ibge.gov.br.

Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS et al. Global prevalence of chronic kidney disease: a systematic review and meta-analysis. PLoS One. 2016; 11(7): e0158765.

Levey AS, STEVENS LA, Schmid CH, Zhang YZ, 3rd AFC, Feldman HI et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12. doi: 10.7326/0003-4819-150-9-200905050-00006

Matsushita K, Selvin E, Bash LD, Astor BC, Coresh J. Risk implications of the new CKD Epidemiology Collaboration (CKD-EPI) equation compared with the MDRD Study equation for estimated GFR: The Atherosclerosis Risk in Communities (ARIC) Study Am J Kidney Dis. 2010; 55(4):648-59. doi: 10.1053/j.ajkd.2009.12.016

National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39(2 Suppl 1): S1‐S266.

Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994; 21(1):55-67.

Organização Mundial da Saúde. Physical status: the use and interpretation of anthropometry. Geneva: WHO; 1995.

Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. Michigan: The Universityof Michigan Press; 1990.

Kuczmarski MF, Kuczmarski RJ, Najjar M. Descriptive anthropometric reference data for older Americans. J Am Diet Assoc. 2000; 100(1):59-66. doi: 10.1016/S0002-8223(00)00021-3

Harrison GG, Buskirk ER, Lindsay Carter JE, Johnston FE, Lohman TG, Pollock ML et al. Skinfold thicknesses and measurement technique. In: Lohman TG, Roche AF, Martorell R. Anthropometric standardisation reference manual: human kinetics books. 1988.

Wieskotten, S, Moissl, U, Chamney, P, Wabel, P. Reference ranges for human body composition and fluid overload. Measurement: 2006.

Menezes CS, Fortes RC. Estado nutricional e evolução clínica de idosos em terapia nutricional enteral domiciliar: uma coorte retrospectiva. Rev Latino-Am Enfermagem. 2019; 27.

Souza VA, Oliveira D, Mansur HN, Fernandes NMS, Bastos MG. Sarcopenia na doença renal crônica. Brazilian Journal of Nephrology. 2015; 0101-2800.

Clementino AV, Patrício AFO, Lins PRM, Oliveira SCP, Gonçalves MCR. Avaliação nutricional de pacientes com insuficiência renal crônica submetidos à hemodiálise em uma clínica de nefrologia em João Pessoa-PB. R Bras Ci Saúde 2014; 18(4):287-96.

Calado IL, França AKTC, Santos AM, Filho MS. Avaliação nutricional de pacientes renais em programa de hemodiálise em um hospital universitário de São Luís do Maranhão. J Bras Nefrol. 2007; 29(4):215-21.

Silva RKB, Silva RKBB, Silva RPB. Perfil nutricional de pacientes renais crônicos da clínica Nefrológica de Caruaru-PE [trabalho de conclusão de curso]. Caruaru: Faculdade do Vale do Ipojuca, Curso de Nutrição; 2010.27p.

Vieira KLD, Gomes VLO, Borba MR, Costa CFS. Atendimento da população masculina em unidade básica de saúde da família: motivos para a (não) procura. Esc Anna Nery. 2013; 17(1):120-7.

D’amico LF, Franco S, Brecailo MK, Freitas AR, Chiconatt P. Caracterização do estado nutricional de pacientes com insuficiência renal crônica em programa de hemodiálise na Cidade de Guarapuava – Paraná. Uniciências. 2013; 17(1):17-24. DOI: 10.17921/1415-5141.2013v17n1p%p

Menezes NPDM, Cintra SRC, Saldanha TF, Ronaldo LJ, Mazza NM. Censo Brasileiro de Diálise: análise de dados da década 2009-2018. Braz J Nephrol. 2020; 42(2):191-200.

Pereira MLAS, Moreira PA, Oliveira CC, Roriz AKC, Amaral MTR, Mello AL et al. Nutritional status of institutionalized elderly Brazilians: a study with the mini nutritional assessment. Nutr Hosp. 2015; 31(3):1198-04.

Pereira IFS, Spyrides MHC, Andrade LMB. Estado nutricional de idosos no Brasil: uma abordagem multinível. Cad Saúde Pública. 2016; 32(5):e00178814.

Gonçalves-Silva RMV, Valente JG, Ferreira MG, Sichieri R. Tabagismo no domicílio e desnutrição em lactentes. Rev Nutr. 2009; 22(1):19-27.

Santos DS, Elias RM, Dalboni MA, Silva GV, Moysés RMA. Pacientes tabagistas apresentam fósforo sérico mais elevado. J Bras Nefrol. 2019; 41(2). DOI: 10.1590/2175-8239-JBN-2018-0156

Boscatto EC, Duarte MFS, Coqueiro RS, Barbosa AR. Estado nutricional em idosos mais velhos e fatores associados. Rev Assoc Med Bras. 2013; 59(1):40-7.

Tarifas D, Barbosa AR, Borgatto AF, Coqueiro RS, Fernandes MH. Fatores associados ao estado nutricional de duas regiões do Brasil. Rev Assoc Med Bras. 2012; 58(4):434-41.

Leite LEA, Resende TL, Nogueira GM, Cruz IBM, Schneider RH, Gottlieb MGV. Envelhecimento, estresse oxidativo e sarcopenia: uma abordagem sistêmica. Rev Bras Geriatr Gerontol. 2012; 15:365-80.

Ghorabi S, Ardehali H, Amiri Z, Shariatpanahi V. Association of the adductor pollicis muscle thickness with clinical outcomes in intensive care unit patients. Nutrition in Clinical Practice. 2016; 31(4):523-6.

Souza VA, Oliveira D, Mansur HN, Fernandes NMS, Bastos MG. Sarcopenia na doença renal crônica. 2015; J Bras Nefrol. 2015; 37(1):98-105.

Carrero JJ, Chmielewski M, Axelsson J, Snaedal S, Heimbürger O, Bárány P et al. Muscle atrophy, inflammation and clinical outcome in incident and prevalent dialysis patients. Clin Nutr. 2008; 27(4):557-64.

Wang AY, Sea MM, Ho ZS, Lui SF, Li PK, Woo J. Evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients. Am J Clin Nutr. 2005; 81(1):79-86.

Fahal IH. Uraemic sarcopenia: aetiology and implications. Nephrol Dial Transplant. 2014; 29(9):1655-65.

Campbell KL, Ash S, Davies PS, Bauer JD. Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. Am J Kidney Dis. 2008; 51(5):748-58.

Published

2021-02-10

How to Cite

1.
Gabriela Monteiro M, Moreira de Lima Pereira P, Teixeira Soares Íris, de Fátima Maria de Oliveira C, Marcus Gomes Bastos M, Carlos Cândido AP. Factors associated with malnutrition in elderly individuals with chronic kidney disease in conservative treatment. HU Rev [Internet]. 2021Feb.10 [cited 2024Jul.17];46:1-8. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/31466

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