Titre
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.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Carrero, J.J.
Auteure/Auteur
Thomas, F.
Auteure/Auteur
Nagy, K.
Auteure/Auteur
Arogundade, F.
Auteure/Auteur
Avesani, C.M.
Auteure/Auteur
Chan, M.
Auteure/Auteur
Chmielewski, M.
Auteure/Auteur
Cordeiro, A.C.
Auteure/Auteur
Espinosa-Cuevas, A.
Auteure/Auteur
Fiaccadori, E.
Auteure/Auteur
Guebre-Egziabher, F.
Auteure/Auteur
Hand, R.K.
Auteure/Auteur
Hung, A.M.
Auteure/Auteur
Ikizler, T.A.
Auteure/Auteur
Johansson, L.R.
Auteure/Auteur
Kalantar-Zadeh, K.
Auteure/Auteur
Karupaiah, T.
Auteure/Auteur
Lindholm, B.
Auteure/Auteur
Marckmann, P.
Auteure/Auteur
Mafra, D.
Auteure/Auteur
Parekh, R.S.
Auteure/Auteur
Park, J.
Auteure/Auteur
Russo, S.
Auteure/Auteur
Saxena, A.
Auteure/Auteur
Sezer, S.
Auteure/Auteur
Teta, D.
Auteure/Auteur
Ter Wee, P.M.
Auteure/Auteur
Verseput, C.
Auteure/Auteur
Wang, AYM
Auteure/Auteur
Xu, H.
Auteure/Auteur
Lu, Y.
Auteure/Auteur
Molnar, M.Z.
Auteure/Auteur
Kovesdy, C.P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1532-8503
Statut éditorial
Publié
Date de publication
2018-11
Volume
28
Numéro
6
Première page
380
Dernière page/numéro d’article
392
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
To better define the prevalence of protein-energy wasting (PEW) in kidney disease is poorly defined.
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.
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.
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.
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.
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.
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.
PID Serval
serval:BIB_2C98C6FBEDEC
PMID
Date de création
2018-11-05T16:15:59.887Z
Date de création dans IRIS
2025-05-20T16:27:05Z