Chronic kidney disease prevence and relationship wiht state of malnutrition in Geriatric patients



Chronic kidney disease (CKD) represents an emerging public health problem. Most elderly patients with CKD present asymptomatically. Despite this, it is clinically significant as it is one of the most potent risk factors for cardiovascular disease. CKD is also accompanied by multiple other comorbidities: hypertension, anaemia, hyperparathyroidism, and renal osteodystrophy. Timely identification and management of CKD can slow its rate of progression and reduce cardiovascular risk by up to 50%.[1] Malnutrition is a major issue in patients with CKD, adversely affecting morbidity, mortality, functional activity and patients’ quality of life. Extensive research in the field of nutrition in patients with CKD has resulted in the formation of general guidelines, although some uncertainties still exist on some of the best therapeutic or preventive options in uremic malnutrition. It is important to search actively for malnutrition since early diagnosis and treatment can improve the prognosis for CKD patients and reduce the monetary costs connected with treatment.[2] Aim: Appreciate CKD presense and relationship with state of malnutrition in Geriatric patients.

Work tasks: 1. To identify the stage III-V chronic kidney disease in Geriatric section patients. 2. Identify the prevalence of malnutrition among Geriatric section patiens. 3. Rate Geriatric section patiens with chronic kidney disease and malnutrition connection.

Methods: Exploring patiens treated VŠĮ KKL Geriatrics secton in December 2014 – February 2015 period. Investigate 115 patients treated in that period in Geriatrics section. The study used MNA – Mini Nutritional Assessment, consisting of anthropometric measurements, the overall assessment of diet data and subjective self-assessment, the maximum number of points -30 [2]. The study was also to assess these patients data: age, last performed blood analysis in serum creatinine. Calculated creatinine clearance by Cockroft-Gault and MDRD formula.Statistical analysis was performed using SPSS version 21 statistical package. The difference was considered statistically significant at p <0.05. Qualitative evidence of interdependence evaluated chi-square (χ2) criteria.

Results:In test group was 31 man (27 proc.) and 84 women (63 proc.), targeted  people age average  ‒ 79,8±8,0 years. Determine III-Vst.  LIL disease spread with Cockroft-Gault formule in Geriatric section patients ‒ 60,9 proc.: III LIL stadium found  46,1 proc., IVst. ‒ 11,3 proc., Vst. ‒ 3,5 proc. Determine  III-V st. LIL disease spread with MDRD formule ‒ 40,9 proc.: III LIL stadium 32,2 proc., IVst. ‒ 5,2 proc., Vst. ‒ 3,5 proc. patients. Malnutrition  found  11,3 proc., malnutrition risk factors found ‒ 63,5 proc. patients. Relation between nutritional status and LIL with  MDRD formule undetermined (p=0,188). Conclusions: 1. III-V stage of LIL determine to 60,9proc. patient using Cockroft-Gault formule and 40,9proc. using MDRD. 2. Malnutrition and malnutrition risk found 74,8proc. of Geriatric section patients.  3. Determine the connection between LIL and malnutrition in Geriatric section patients using Cockroft-Gault formule.