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Nutrients
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Nutritional Status and the Risk of Malnutrition in People with...
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Nutritional Status and the Risk of Malnutrition in People with Kidney Failure

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 1114

Special Issue Editor

Dr. Jessica Dawson

E-Mail Website
Guest Editor
1. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia
2. Nutrition and Dietetics Department, St George Hospital, Sydney, Australia
Interests: clinical nutrition; dietetics; nutritional and metabolic diseases; chronic kidney disease; supportive care; renal; kidney function; palliative care; kidney disease; kidney supportive care

Special Issue Information

Dear Colleagues,

Malnutrition is a common clinical complication in kidney failure, with rates of malnutrition increasing as kidney disease progresses. The pathophysiological mechanisms of malnutrition in kidney failure are numerous and complex, leading to worse patient outcomes, reduced quality of life, and shorter survival. Early identification and intervention are crucial to halt or delay the progression of malnutrition. This Special Issue aims to explore novel research related to the identification and management of malnutrition in people with chronic kidney disease, including people receiving kidney replacement therapies and conservative kidney management. We invite authors to contribute original research, reviews, and unique perspectives addressing the identification and management of malnutrition. Topics can include conditions related to malnutrition, such as protein energy wasting, sarcopenia, and frailty, as long as the relevance and/or impact on malnutrition is clear.

Key themes include, but are not limited to, the following:

  • Mechanisms related to the development of malnutrition, including nutrition impact symptoms, inflammation, uraemia, and metabolic derangements.
  • Novel nutritional interventions targeting malnutrition.
  • Novel interventions targeting the mechanistic causes of malnutrition.
  • The role of energy and protein in malnutrition management, particularly in nondialysis chronic kidney disease.

Dr. Jessica Dawson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic kidney disease
  • kidney replacement therapy
  • dialysis
  • malnutrition
  • protein energy wasting

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Published Papers (2 papers)

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Research

12 pages, 2936 KiB  
Article
Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients
by Sadamu Takahashi, Tatsuki Tanaka, Yusuke Suzuki, Norihito Yoshida, Mai Hitaka, Shingo Ishii, Keisuke Yamazaki, Motoyuki Masai, Yosuke Yamada and Yasushi Ohashi
Nutrients 2025, 17(11), 1896; https://doi.org/10.3390/nu17111896 - 31 May 2025
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Abstract
Background/Objectives: Malnutrition, muscle wasting, and fluid overload are highly prevalent in patients undergoing maintenance hemodialysis (HD) and may contribute to increased mortality risk. However, the combined impact of these factors has not been fully elucidated. Methods: In this multicenter prospective cohort [...] Read more.
Background/Objectives: Malnutrition, muscle wasting, and fluid overload are highly prevalent in patients undergoing maintenance hemodialysis (HD) and may contribute to increased mortality risk. However, the combined impact of these factors has not been fully elucidated. Methods: In this multicenter prospective cohort study, we enrolled 368 patients in maintenance HD at four dialysis facilities in Japan. Malnutrition was defined as moderate or higher nutritional risk using the nutritional risk index for Japanese hemodialysis patients (NRI-JH). Low muscle mass was assessed using the skeletal muscle mass index (SMI) according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) was defined as values in the top quartile (≥7650 pg/mL). Mortality risk was analyzed using Cox proportional hazards models. Associations with inflammation, assessed by C-reactive protein (CRP), were also explored. Results: Over a three-year follow-up period, 52 deaths occurred. Malnutrition, low muscle mass, and elevated NT-proBNP were each independently associated with increased all-cause mortality (HR: 4.98, 3.25, and 5.45, respectively). Patients with multiple concurrent risk factors had significantly worse survival. Although CRP was positively associated with these risk factors, it was not an independent predictor of mortality. Conclusions: Malnutrition, low muscle mass, and elevated NT-proBNP are independent and additive risk factors for mortality in HD patients. These findings highlight the need for integrated assessment and management strategies to improve prognoses in this high-risk population. Full article
(This article belongs to the Special Issue Nutritional Status and the Risk of Malnutrition in People with Kidney Failure)
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15 pages, 4421 KiB  
Article
Temporal Trends and Clinical Impact of Malnutrition on In-Hospital Outcomes Among Patients with Advanced Chronic Kidney Disease: A Nationwide Inpatient Analysis
by Wannasit Wathanavasin, Charat Thongprayoon, Wisit Kaewput, Supawit Tangpanithandee, Supawadee Suppadungsuk and Wisit Cheungpasitporn
Nutrients 2025, 17(9), 1508; https://doi.org/10.3390/nu17091508 - 29 Apr 2025
Viewed by 552
Abstract
Background/Objectives: Malnutrition is a prevalent yet under-recognized condition in patients with advanced chronic kidney disease (CKD), contributing to increased morbidity, mortality, and healthcare burden. The aim of this study is to determine the prevalence and trends of malnutrition and investigate the impact of [...] Read more.
Background/Objectives: Malnutrition is a prevalent yet under-recognized condition in patients with advanced chronic kidney disease (CKD), contributing to increased morbidity, mortality, and healthcare burden. The aim of this study is to determine the prevalence and trends of malnutrition and investigate the impact of malnutrition on in-hospital outcomes, treatments, and resource utilization in hospitalized patients with advanced CKD. Methods: This study utilized the National Inpatient Sample (NIS) database to identify hospitalized patients with advanced CKD from 2016 to 2021. This study investigated temporal trends in the prevalence and in-hospital mortality across different degrees of malnutrition in advanced CKD patients. Multivariable regression models were used to assess the association between malnutrition and in-hospital outcomes. Results: Out of 1,244,415 advanced CKD patients, 67,587 (5.4%) had mild to moderate malnutrition, and 63,785 (5.1%) had severe malnutrition. Malnourished patients exhibited significantly higher in-hospital mortality, with adjusted odds ratios of 1.70 (95% confidence interval (CI), 1.64–1.75) for mild to moderate cases and 2.67 (95% CI, 2.60–2.75) for severe cases. Severely malnourished patients were associated with longer mean hospital stay by 7.0 days and higher hospitalization costs by $97,767 compared with non-malnourished patients. The prevalence of severe malnutrition showed a significant uptrend from 4.2% in 2016 to 5.5% in 2021 (p for trend < 0.001). Conclusions: Malnutrition in advanced CKD is an increasingly prevalent condition linked to worsened in-hospital outcomes and heightened healthcare resource utilization. The rising trend of severe malnutrition underscores the need for early nutritional screening and the need for future interventional studies to mitigate adverse clinical outcomes in this high-risk population. Full article
(This article belongs to the Special Issue Nutritional Status and the Risk of Malnutrition in People with Kidney Failure)
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