Nutritional disorders and survival rate of elderly and geriatric patients with CKD 3B-5 stage

Abstract

BACKGROUND. The prevalence of CKD in the population of the elderly and geriatric patients is varies from 23.4% to 35.8%. Nutritional status was recognized as an important factor of CKD prognosis. One of the factors affecting their survival is nutritional status. There have not been many studies on the effect of eating disorders on the survival of elderly and senile patients with CKD.THE AIM: to assess the impact of nutritional status on the survival of elderly patients with CKD stages 3b-5.PATIENTS AND METHODS. We’ve studied 190 people with CKD stages 3b-5 (eGFR<45 ml/min/m2) with an average age of 76 [67;86]. Exclusion criteria’s: dialysis, acute cardiovascular disorders, oncology, and psychiatric disorders. Nutritional status was assessed by Subjective Global Assessment scale, the 5-year risk of the death was evaluated absolute by the Bansal scale. The duration of study - 36 month.RESULTS. In the group of elderly and geriatric patients with CKD stages 3b-5, normal nutritional status was determined in 40.1% of patients, mild to moderate malnutrition in 54.7%, and protein-energy wasting (PEW) in 5.2%; up to 2.8% of patients were underweight. The best 3-year survival rate was observed in patients with normal nutritional status, mild nutritional status disorders and obesity, the worst survival rate - in patients with PEW and underweight (p<0,001).  In the group of patients with CKD stage 4 the average Bansal score scale was 8 points, which corresponds to 69% of the absolute risk of death within 5 years; in patients with CKD stage 5, the average score was also 8 [7, 8]. CONCLUSION. In the group of elderly and geriatric patients with CKD stage 3b-5 and PEW survival rate was significantly lower than in patients without nutritional disorders and mild nutritional disorders; we didn’t find correlation between the estimated absolute risk of death according to the Bansal scale and actual survival in 3-year observation period.