Dr Jessica Dawson1,2, Ms Ann-Maree Randall3,4, Ms Michele Ryan4, Mr Frank P Brennan5, Dr Chenlei-Kelly Li5,6, Mr Cameron McLean1, Dr Brendan J Smyth2,5, Mr Max Thomsett5, Professor Mark A Brown5,6
1Department of Nutrition and Dietetics, St George Hospital, Sydney, Australia, 2NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, 3Department of Nutrition and Dietetics, Nepean Hospital, Kingsford, Australia, 4Western Renal Service, Sydney, Australia, 5Department of Renal Medicine, St George Hospital, Sydney, Australia, 6School of Clinical Medicine, University of New South Wales Medicine and Health, Sydney, Australia
Aim: Describe the prevalence of malnutrition and frailty and the association of dietary intake in patients commencing a non-dialysis Conservative Kidney Management (CKM) pathway.
Background: Identification and management of frailty and malnutrition are important components of chronic kidney disease (CKD) management. There is a paucity of data reporting the association of dietary energy and protein intake with rates of malnutrition and frailty in people commencing a CKM pathway.
Methods: Prospective study of people commencing a CKM pathway who were recruited at their initial kidney supportive care clinic between July 2018 – September 2020. Frailty and malnutrition were assessed using the Fried’s Frailty Index and 7-Point Subjective Global Assessment (SGA), respectively. Dietary intake was assessed by 24-hour dietary recall undertaken by a renal dietitian.
Results: Sixty participants were recruited with an average age of 81 years and eGFR 12mL/min/1.73m2. At baseline, 23 patients were identified as malnourished (38.3%) and 42 as frail (70.0%). There was no difference in energy intake between those assessed as frail (1450kcal) and not-frail (1265kcal) (p=0.07) and no difference in protein intake in those assessed as frail (64g, equivalent to 0.87g/kg/d) and not-frail (67g, equivalent to 1.00/kg/d) (p=0.66). Similarly, there was no difference in energy intake in those malnourished and well nourished, 1291kcal and 1460kcal, respectively (p=0.122). However, there was a significant difference in protein intake in those malnourished and those well-nourished, 53g (equivalent to 0.8g/kg/d) and 72g (equivalent to 0.99g/kg/d), respectively (p<0.03).
Conclusions: Frailty and malnutrition are common in people commencing a CKM pathway. Protein intake was lower in those assessed as malnourished. Given guideline recommendations for lower protein intake for people on a CKM pathway, this warrants further exploration.
Biography:
Jess is a research fellow and renal dietitian with over 10 years clinical experience. Jess’s goal is to combine her clinical practice with innovative research in nutritional management to improve care and outcomes in people with chronic kidney disease. Jess’ experience and interest is in novel interventions to improve dietary behaviours and management of people choosing Conservative Kidney Management.