Juan J Carrero1, Fridtjof Thomas2, Kristóf Nagy3, Fatiu Arogundade4, Carla M Avesani5, Maria Chan6, Michal Chmielewski7, Antonio C Cordeiro8, Angeles Espinosa-Cuevas9, Enrico Fiaccadori10, Fitsum Guebre-Egziabher11, Rosa K Hand12, Adriana M Hung13, Talat A Ikizler13, Lina R Johansson14, Kamyar Kalantar-Zadeh15, Tilakavati Karupaiah16, Bengt Lindholm17, Peter Marckmann18, Denise Mafra19, Rulan S Parekh20, Jongha Park21, Sharon Russo20, Anita Saxena22, Siren Sezer23, Daniel Teta24, Pieter M Ter Wee25, Cecile Verseput26, Angela Y M Wang27, Hong Xu17, Yimin Lu24, Miklos Z Molnar2, Csaba P Kovesdy2. 1. Department of Medical Epidemiology and Biostatistics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden. Electronic address: juan.jesus.carrero@ki.se. 2. Division of Biostatistics (FT), Department of Preventive Medicine, and Division of Nephrology, Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee. 3. Department of Transplantation and Surgery, Semmelweis University, Budapest. 4. Obafemi Awolowo University, Nigeria. 5. Department of Medical Epidemiology and Biostatistics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden; Nutrition Institute, Rio de Janeiro State University, Brazil. 6. Department of Nutrition and Dietetics, The St. George Hospital, Kogarah, Australia. 7. Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Poland. 8. Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil. 9. Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico. 10. Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy. 11. Department of Nephrology, Dialysis, Hypertension, Hôpital Edouard Herriot, Hospices Civils de Lyon, Claude Bernard University, Lyon, France. 12. Division of Nephrology, University of Ulsan College of Medicine, Ulsan, Republic of Korea. 13. Department of Medicine, Division of Nephrology and Hypertension and Vanderbilt Center for Kidney Diseases Vanderbilt University Medical Center, Nashville, TN; Veterans Administration Tennessee Valley Healthcare System, Nashville, TN. 14. Department of Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, UK. 15. Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Orange, California. 16. School of Biosciences, Faculty of Health & Medical Science, Taylor's University Lakeside Campus, Malaysia. 17. Department of Medical Epidemiology and Biostatistics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden. 18. Sjællands University Hospital, Roskilde, Denmark. 19. Graduate Program in Medical Sciences and Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói-RJ, Brazil. 20. Division of Nephrology, Departments of Pediatrics and Medicine, Hospital for Sick Children, University Health Network and University of Toronto, Canada. 21. Case Western Reserve University Department of Nutrition, Cleveland, Ohio. 22. Department of Nephrology, Sanjay Gandhi Post Graduate, Institute of Medical Sciences, Lucknow, India. 23. Baskent University Faculty of Medicine, Ankara, Turkey. 24. Service of Nephrology, Hospital of Sion, University of Lausanne, Switzerland. 25. Department of Nephrology VUmc, ICaR-VU, Amsterdam. 26. Johannesburg, Gauteng, South Africa. 27. Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Abstract
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.
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.
Authors: Cihan Heybeli; Pinar Soysal; Mehmet Asi Oktan; Lee Smith; Ali Çelik; Rumeyza Kazancioglu Journal: Aging Clin Exp Res Date: 2021-08-27 Impact factor: 3.636
Authors: Angela Yee-Moon Wang; Ikechi G Okpechi; Feng Ye; Csaba P Kovesdy; Giuliano Brunori; Jerrilynn D Burrowes; Katrina Campbell; Sandrine Damster; Denis Fouque; Allon N Friedman; Giacomo Garibotto; Fitsum Guebre-Egziabher; David Harris; Kunitoshi Iseki; Vivekanand Jha; Kailash Jindal; Kamyar Kalantar-Zadeh; Brandon Kistler; Joel D Kopple; Martin Kuhlmann; Meaghan Lunney; Denise Mafra; Charu Malik; Linda W Moore; S Russ Price; Alison Steiber; Christoph Wanner; Pieter Ter Wee; Adeera Levin; David W Johnson; Aminu K Bello Journal: Clin J Am Soc Nephrol Date: 2022-01-03 Impact factor: 8.237
Authors: A Gaipov; O Cseprekal; P K Potukuchi; K Kabulbayev; A Remport; Z Mathe; M Talwar; V Balaraman; T Fülöp; J D Eason; I Mucsi; C P Kovesdy; M Z Molnar Journal: Osteoporos Int Date: 2018-11-19 Impact factor: 4.507