Abstract: SA-PO058

Nutritional Assessment of Patients in the Recovery Phase of Moderate to Severe AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Macedo, Etienne, University of California San Diego, San Diego, California, United States
  • Kumar, Vivek, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Sahni, Nancy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • Gupta, Krishan Lal L., Postgraduate Institute of Medical Education & Research, Chandigarh, India
  • Mehta, Ravindra L., University of California San Diego, San Diego, California, United States
Background

The role of nutritional status has not been studied in the recovery phase of AKI. Although protein restriction could reduce the tubular workload in the recovering kidney, malnutrition is common and may affect overall patient outcome. In order to further our understanding of the role of nutrition, we evaluated parameters of nutrition status in patients during the recovery phase of AKI.

Methods

This is an analysis of preliminary data from a pilot single center, open-label, randomized controlled, trial of patients who have an episode of Stage 2/3 AKI. Baseline CKD Stage 4 or higher, need of RRT for>2weeks or dialysis dependency at hospital discharge were exclusion criteria. A screening and comprehensive nutritional assessment was performed by a dietitian and quality of well-being, along with bioelectrical impedance measurments, blood and urine tests.

Results

Of 32 enrolled patient, mean age was 41yo, 43% were male, 38% had hypertension and 13% DM. Of 26 patients with complete nutritional assessment, 23% were classified as normal nutritional status, 46% at risk of malnutrition and 30% as malnourished. Only 3 patients were admitted to an ICU and 23 were dialyzed during hospital stay. Most patients lost weight at discharge, mean difference from admission was 5.5 kgs, with a trend to be higher in patients at risk of malnutrition (7kg) and malnourished (6kg), as compared to normal nutritional status (4.5kg). At hospital discharge charlson comorbidity index, EQ-5D-5L, albumin (3.8±0.7g/dl) and sCR (3.3±1.7mg/dl) values were not different by nutritional category status. Evaluation of body composition showed that all patients had decreased muscle mass according to normal age/gender composition. Fat mass was increased in 41% of patients at risk for malnutrition, as compared to 17% in normal and 24% in malnourished patients. The mini nutritional assessment (MNA) screening had a good correlation with the complete nutritional assessment; r=.842 (p<0.001).

Conclusion

Patients recovering from an AKI episode are at increased risk for malnutrition, particularly those undergoing dialysis during hospital stay. Nutritional screening is a simple, rapid and sensitive process that can detect all or nearly all of the patients at nutritional risk. Further evaluation including body composition may help to determine patients in need of nutritional follow up.