Global prevalence of protein-energy wasting in kidney disease: A meta-analysis of contemporary observational studies from the international society of renal nutrition and metabolism
Pharm, Juan J Carrero; Biostat, Fridtjof Thomas; Nagy, Kristof; Arogundade, Fatiu; Avesani, Carla M; Chan, Maria; Chmielewski, Michal; Cordeiro, Antonio C; Espinosa-Cuevas, Angeles; Fiaccadori, Enrico; Guebre-Egziabher, Fitsum; Hand, Rosa K; Hung, Adriana M; Ikizler, Talat A; Johansson, Lina R; Kalantar-Zadeh, Kamyar; Karupaiah, Tilakavati; Lindholm, Bengt; Marckmann, Peter; Mafra, Denise; Parekh, Rulan S; Park, Jongha; Russo, Sharon; Saxena, Anita; Sezer, Siren; Teta, Daniel; Ter Wee, Pieter M; Wang, Angela Y M; Xu, Hong; Lu, Yimin; Molnar, Miklos Z; Kovesdy, Csaba P.
J. renal nutr
; 28(6): 380-392, Nov. 2018. graf, ilus, tab
Artículo
en Inglés
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1152273
Objective:
To better define the prevalence of protein-energy wasting (PEW) in kidney disease is poorly defined.Methods:
We performed a meta-analysis of PEW prevalence from contemporary studies including more than 50 subjects with kidney disease, published during 2000-2014 and reporting on PEW prevalence by subjective global assessment or malnutrition-inflammation score. Data were reviewed throughout different strata (1) acute kidney injury (AKI), (2) pediatric chronic kidney disease (CKD), (3) nondialyzed CKD 3-5, (4) maintenance dialysis, and (5) subjects undergoing kidney transplantation (Tx). Sample size, period of publication, reporting quality, methods, dialysis technique, country, geographical region, and gross national income were a priori considered factors influencing between-study variability.Results:
Two studies including 189 AKI patients reported a PEW prevalence of 60% and 82%. Five studies including 1776 patients with CKD stages 3-5 reported PEW prevalence ranging from 11% to 54%. Finally, 90 studies from 34 countries including 16,434 patients on maintenance dialysis were identified. The 25th-75th percentiles range in PEW prevalence among dialysis studies was 28-54%. Large variation in PEW prevalence across studies remained even when accounting for moderators. Mixed-effects meta-regression identified geographical region as the only significant moderator explaining 23% of the observed data heterogeneity. Finally, two studies including 1067 Tx patients reported a PEW prevalence of 28% and 52%, and no studies recruiting pediatric CKD patients were identified.Conclusion:
By providing evidence-based ranges of PEW prevalence, we conclude that PEW is a common phenomenon across the spectrum of AKI and CKD. This, together with the well-documented impact of PEW on patient outcomes, justifies the need for increased medical attention.
Biblioteca responsable:
BR79.1
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