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Nutrients 2016, 8(10), 662; doi:10.3390/nu8100662

Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

1
Department of Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo 143-8541, Japan
2
Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, 564-1, Shimoshizu, Sakura, Chiba 285-8741, Japan
3
Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima 731-5134, Japan
4
Department of Nutrition, Omori Medical Center, Toho University, Tokyo 143-8541, Japan
*
Author to whom correspondence should be addressed.
Received: 31 August 2016 / Revised: 7 October 2016 / Accepted: 14 October 2016 / Published: 23 October 2016
(This article belongs to the Special Issue Nutrition and Chronic Kidney Disease)
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Abstract

Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = −0.33, p < 0.001) and those with lower glomerular filtration rate (r = 0.47, p < 0.001). The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61–15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49–37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority. View Full-Text
Keywords: body mass index; body composition; chronic kidney disease; food intake; geriatric nutritional risk index; nutritional status; serum albumin; wasting syndrome body mass index; body composition; chronic kidney disease; food intake; geriatric nutritional risk index; nutritional status; serum albumin; wasting syndrome
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MDPI and ACS Style

Kiuchi, A.; Ohashi, Y.; Tai, R.; Aoki, T.; Mizuiri, S.; Ogura, T.; Aikawa, A.; Sakai, K. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study. Nutrients 2016, 8, 662.

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