Central obesity - the most common nutritional disorder in non-frail patients with chronic kidney disease

中心性肥胖——慢性肾病非体弱患者中最常见的营养障碍

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Abstract

INTRODUCTION: Patients with chronic kidney disease (CKD) often experience various nutritional disorders, leading to increased frailty, morbidity, and mortality. The aim of our study was to explore the impact of dietary habits and physical activity on body composition in non-dialysis CKD patients. MATERIALS AND METHODS: This cross-sectional study included 199 non-frail CKD patients (stages 1 - 5) from the University Medical Center Ljubljana. Participants completed a food frequency questionnaire, and anthropometric measurements were collected. Body composition was assessed using bioelectrical impedance analysis (BIA), and muscle strength was evaluated with handgrip dynamometry. RESULTS: Central obesity was present in 79.9% of participants, and obesity based on body mass index (BMI) was found in 26.6%. Elevated fat mass was observed in 58.3% of patients. Sarcopenia was identified in 1%, and sarcopenic obesity in 0.5%. Based on the Global Leadership Initiative on Malnutrition (GLIM) criteria, 11.6% of patients were malnourished. Dietary analysis revealed too frequent intake of refined carbohydrates, red meat, and sweets, while intake of fruits and vegetables was not often enough. Dietary habits were suboptimal, with no significant differences between individuals with normal waist circumference and BMI and those with central obesity and elevated BMI. However, a significant difference was observed in physical activity, with those having central obesity engaging in less physical activity. CONCLUSION: Central obesity was the most prevalent nutritional disorder in non-frail CKD patients that was markedly more prevalent than obesity defined by BMI. Waist circumference was a more sensitive marker of increased fat mass determined with BIA than BMI. Inadequate dietary habits and insufficient physical activity were major contributing factors to the observed nutritional disorders in our CKD patients and call for long-term lifestyle modifications.

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