Nutritional disorders among elderly and senile patients depending on the state of renal function
E.G. Borkhanova, A.N. Maksudova, S. Alaskari, M. Derbali, E.A. Konyukhov
1) Kazan State Medical University, Kazan, Russia;
2) Dialysis Clinic LLC, Kazan, Russia
Background. In elderly and senile patients, malnutrition is often detected; it is associated with an increased risk of chronic diseases, a decrease in antioxidant protection, impaired immune system function, an increased risk of fractures, and senile asthenia.
Objective. Assessment of the prevalence of nutritional disorders among elderly and senile patients depending on the state of renal function.
Material and methods. A study included 220 patients: 150 with stage 3B-5 chronic kidney disease (CKD) and 70 without signs of CKD. The nutritional status according to the Minimal Nutrition Assessment (MNA), anthropometric and laboratory indicators of nutritional status were evaluated, polymorbidity was assessed, and the Charlson comorbidity index was calculated.
Results. In the group of elderly and senile patients with stage 3B-5 CKD, the frequency of malnutrition was 21% versus 8.6% in patients without CKD; 54% of elderly patients with CKD and 25.7% of patients without CKD were at risk of developing nutritional disorders. Laboratory indicators of nutritional status in both groups correlated with the results of the Brief Nutritional Assessment Scale: with an increase in nutritional disorders, progression of anemia, hypoproteinemia, and a decrease in total cholesterol were observed. Thus, in the group of patients with stage 3B-5 CKD, nutritional disorders were observed significantly more often (P<0.05). The mean score of the Charlson comorbidity index in patients aged 60 years and older with CKD stage 3B-5 was 5 (4-6) points, which was also significantly higher than the comorbidity index in the group of patients without CKD – the mean score was 3 (2-5) (P<0.001) and correlated with eGFR level (r=-0.44; P<0.05).
Conclusion. The prevalence of malnutrition in patients older than 60 years with stage 3B-5 CKD was 21%. Elderly and senile patients with pre-dialysis stages of CKD have a higher risk of developing nutritional disorders than patients without signs of CKD, and a higher Charlson comorbidity index.
About the Autors
Elina G. Borkhanova – Postgraduate Student, Department of Hospital Therapy, Kazan State Medical University, Kazan, Russia; e-mail: firstname.lastname@example.org ORCID: orcid.org/0000-0001-9308-3332
Adela N. Maksudova – Dr. Sci. (Med.), Professor at the Department of Hospital Therapy, Kazan State Medical University, Kazan, Russia; e-mail: email@example.com ORCID: orcid.org/0000-0003-4237-4695
Sokhaib Alaskari – Internal Medicine Resident, Kazan State Medical University, Kazan, Russia; e-mail:firstname.lastname@example.org
Mohammed Derbali – Internal Medicine Resident, Kazan State Medical University, Kazan, Russia; e-mail: email@example.com
Evgeny A. Konyukhov – Nephrologist at OOO “Dialysis Clinics”, Head of Department of Internal Quality Control and Safety of Medical Activities, NephroMed Group, Kazan, Russia; e-mail: firstname.lastname@example.org