Analysis of nutritional status and influencing factors of malnutrition before dialysis in chronic kidney disease patients

Objective To investigate the nutritional status of chronic kidney disease (CKD) patients before dialysis and the influencing factors of malnutrition. Methods A total of 134 patients with pre-dialysis CKD patients in the nephrology department of the First Affiliated Hospital of Bengbu Medical College from September 2018 to March 2019 were selected as the study subjects. Subjective Global Assessment (SGA) and laboratory tests were used to assess the nutritional status of CKD patients. Patients were grouped according to the results of SGA and the clinical data, including general information, medical history, nutrition education and treatment, were collected. Multivariate logistic regression analysis was used to screen the risk factors of malnutrition in CKD patients. Results Among 134 patients, 107(79.9%) were well-nourished, 20(14.9%) were moderately malnourished, 7(5.2%) were severely malnourished. The incidence of CKD stage 1-5 malnutrition was 6.9%, 5.4%, 30.4%, 39.1% and 31.8%, respectively. There were significant differences in hemoglobin, albumin, prealbumin, creatinine and urea among the three groups (all P<0.05). Multivariate logistic regression analysis showed that age (> 65 years old), C-reactive protein (≥3 mg/L), CKD 3-5 stage and diabetes mellitus were risk factors for malnutrition in CKD patients. Conclusion The prevalence of malnutrition in pre-dialysis CKD patients is high, especially in CKD 3-5 stage. The age (≥65 years old), C-reactive protein (≥3 mg/L), CKD 3-5 stage and diabetes mellitus are independent risk factors for malnutrition in pre-dialysis CKD patients. Therefore, we should strengthen the understanding of malnutrition in pre-dialysis CKD patients, pay attention to screen the above risk factors, take active nutritional treatment measures, reduce the incidence of malnutrition in CKD patients before dialysis, and improve the quality of life of patients.