Assessment of Malnutrition Risk and Analysis of Influencing Factors in Patients with Chronic Kidney Disease：A cross-sectional survey

Objective: To assess the status of malnutrition risk in patients with chronic kidney disease (CKD) using objective nutritional indices and to analyze the influencing factors. Methods: 1277 patients with CKD admitted to the Department of Nephrology at a Class A hospital in Nanjing from 2020 to 2022, were selected for this study. The Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) were used to evaluate the risk of malnutrition. Logistic regression analysis identified associated risk factors. Results: PNI and CONUT assessment indicated that 1138 (89.1%) and 1120 (87.7%) of the 1277 patients were at risk of malnutrition, respectively. The weighted kappa coefficient between the two methods was 0.368, showing moderate consistency. Patients at moderate to high risk of malnutrition had longer hospital stays. In the PNI assessment, patients at moderate or high malnutrition risk had significantly higher CKD stages, older age, and elevated blood urea nitrogen (BUN) and creatinine levels, along with lower BMI, hemoglobin (Hb), lymphocyte count, and albumin. Similarly, in the CONUT assessment, patients at moderate or high malnutrition risk had higher age, BUN, and creatinine levels, along with significantly lower levels of BMI, Hb, lymphocyte count, albumin, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Logistic regression analysis identified CKD stage ≥ 4, age ≥ 65 years, and BUN ≥ 9.5 mmol/L as risk factors for malnutrition in the PNI assessment. In the CONUT assessment, Hb ≤ 110 g/L, age ≥ 65 years, and BMI ≤ 18.5 kg/m ² were identified as risk factors. Conclusion: CKD Patients face a high risk of malnutrition, emphasizing the need for regular screening and assessment. Understanding and addressing the identified risk factors through targeted interventions is crucial for improving patient outcomes.