Search Results (490)

Background/Objectives: Cancer is a complex disease that affects patients’ nutritional and psychological status. This study aimed to assess the nutritional status of patients diagnosed with lung and gastrointestinal system cancers and evaluate its association with anthropometric measurements, nutrient intake, and psychological symptoms. Methods: This cross-sectional study was conducted with 180 patients with lung and gastrointestinal system cancers. Data were collected face-to-face by a questionnaire that included the Subjective Global Assessment-(SGA), Cachexia Assessment Criteria, 24 h Food Consumption Record, and Symptom Checklist-90-Revised-(SCL-90-R). Some anthropometric measurements were collected. Results: Body Mass Index (BMI) was found to be significantly lower (p < 0.001) in SGA-B (moderately malnourished) and SGA-C (severely malnourished) compared to those in SGA-A (well-nourished). The calf circumference was significantly lower (p = 0.002) in SGA-C compared to those in SGA-A and SGA-B. The mean SGA scores were found to be higher in cachexia-diagnosed participants (p < 0.001). The energy intake of SGA-C was significantly lower than SGA-A and SGA-B (p < 0.001). In addition, the energy intake of SGA-B was lower than SGA-A (p < 0.001). The protein intake of SGA-C was lower than SGA-A and SGA-B (p < 0.001). The protein intake of SGA-B was lower than SGA-A (p < 0.001). Regarding the intake of vitamins A, C, E, B1, and B6 and carotene, folate, potassium, magnesium, phosphorus, iron, and zinc, SGA-B and SGA-C were significantly lower than SGA-A (p < 0.001). Additionally, only phobic anxiety was found to be significantly higher in SGA-B than in SGA-A (p: 0.024). Conclusions: As the level of malnutrition increased, a reduction in some nutrient intake and anthropometric measurements was observed. No significant difference was found in any psychological symptoms except phobic anxiety. With this in mind, it is important that every cancer patient, regardless of the stage of the disease, is referred to a dietitian from the time of diagnosis. Full article

Background/Objectives: Malnutrition in older adults is both preventable and treatable, yet its detection and etiology remain complex. Therefore, the aim of this study was to evaluate the prevalence of malnutrition and various factors involved in the etiology of malnutrition in community-dwelling individuals aged 65 years and older. Methods: This cross-sectional study was conducted with community-dwelling individuals aged 65 years and older in a health center in Ağrı, Türkiye. The nutritional status of older adults was measured using the Mini Nutritional Assessment (MNA). Data were collected through face-to-face interviews and a series of validated instruments, including the Standardized Mini Mental Examination (MMSE), body composition measurements (BIA), dietary intake records, and physical performance tests such as hand grip strength, chair stand, and Timed ‘Up & Go’ (TUG) Test. Statistical analyses included chi-square and Mann-Whitney U tests for group comparisons and logistic regression to investigate independent factors associated with risk of malnutrition. Results: A total of 182 participants were included in the study. The mean age of the participants was 72.1 ± 6.0 years. Of the participants, 59.3% were male. 1.6% of the participants were malnourished, and 25.3% were at risk of malnutrition. Perceived health status compared to peers (OR: 1.734, 95% CI: 1.256–2.392, p = 0.001), lower appetite status (OR: 1.942, 95% CI: 1.459–2.585, p < 0.001) and lower waist circumference (OR: 1.089, 95% CI: 1.040–1.140, p < 0.001) were independent predictors of malnutrition risk. Conclusions: The risk of malnutrition was higher among individuals with lower appetite, poorer self-perceived health status compared to peers, and smaller waist circumference. Reduced physical function and strength were also associated with an increased risk of malnutrition. Full article

Background/Objective: This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). Methods: In this retrospective cohort study using the 2011–2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status. Frail patients were then classified according to malnutrition and anemia status. Frailty was determined using the revised risk analysis index (RAI-rev). Our primary outcomes were extended length of stay (LOS), non-routine discharge (NRD), 30-day adverse events (AE), and 30-day mortality. For each outcome, we fitted four nested multivariable logistic regression models (RAI-rev + anemia + malnutrition, RAI-rev + anemia, RAI-rev + malnutrition, and RAI-rev alone) and compared the incremental discrimination of each model using receiver operating characteristic (ROC) analysis. Results: Of 3639 patients, 460 were frail alone, 266 were frail + anemic, 37 were frail + malnourished, 121 were frail + anemic + malnourished, and 2755 were not frail. RAI-rev (aOR: 1.84, 95% CI: 1.45–2.35), anemia (aOR: 1.84, 95% CI: 1.45–2.35), and malnourishment (aOR: 2.34, 95% CI: 1.69–3.24) were independent predictors of extended LOS. RAI-rev (aOR: 1.07, 95% CI: 1.04–1.11) and anemia (aOR: 2.09, 95% CI: 1.66–2.61) were associated with an increased risk of 30-day AEs. RAI-rev and malnutrition were independent predictors of NRD (RAI-rev: aOR: 1.11, 95% CI: 1.06–1.16; Malnutrition: aOR: 1.57, 95% CI: 1.08–2.29) and 30-day mortality (RAI-rev: aOR: 1.10, 95% CI: 1.04–1.17; Malnutrition: aOR: 3.79, 95% CI: 1.24–11.60). Based on ROC analysis, RAI-rev + anemic + malnourished was a superior predictor of LOS and 30-day AEs (both p < 0.001). Compared to RAI-rev, RAI-rev + anemic superiorly predicted LOS and 30-day AEs, and RAI-rev + malnutrition superiorly predicted LOS (all p < 0.001). Conclusions: Our results reveal RAI-rev combined with malnutrition and anemia superiorly predicts 30-day AEs and LOS in postoperative ASD patients. Future studies should investigate the feasibility and efficacy of these models for perioperative risk stratification and optimized recovery planning to improve outcomes for ASD patients. Full article

Background: There is little information about the effectiveness of oral nutritional supplements (ONS) in combatting nutrient inadequacies in primary care, where most malnutrition exists. Aim: To examine the extent to which readymade ONS add or displace the nutrients consumed in the diet and their impact on combatting dietary inadequacies. Methods: 308 free-living people >50 years with medium + high risk of malnutrition (Malnutrition Universal Screening Tool) were randomised to receive readymade low volume (2.4 kcal/mL), liquid ONS plus dietary advice (ONS + DA) or dietary advice alone (DA). Intake was assessed at baseline (24 h recall) and 4-weekly for 12 weeks (3-day diet record). Total nutrient intake was benchmarked against UK and European dietary reference values (DRVs). The proportion of energy and nutrients from the ONS that added or displaced those from the diet (net addition/displacement) was calculated. Results: ONS + DA led to significantly greater total energy and nutritional intakes, with 25/29 nutrient intakes significantly higher than with DA alone. There were no significant differences in dietary energy and nutrient intakes from food between the groups. There was little or no displacement of nutrients from the diet, with over 90% of the energy and nutrients consumed in the ONS additive to the diet. ONS + DA more than halved the number of people with nutrient intakes that failed to meet DRVs and the number of nutrients per person that did not meet DRVs compared to DA alone. Conclusions: Supplementation with readymade, low volume (2.4 kcal/mL) liquid ONS overcomes most nutrient intake inadequacies in malnourished older people in primary care without significantly reducing intake from the diet. This makes ONS an effective way to improve nutritional intakes above dietary advice alone to improve the outcomes for the management of older people at risk of malnutrition. Full article

Background: The Malnutrition Screening Tool (MST) is commonly used to identify malnutrition risk; however it has demonstrated poor sensitivity to detect malnutrition in inpatients with chronic kidney disease (CKD) and kidney replacement therapy (KRT) populations. Gastrointestinal symptoms, such as poor appetite, may better detect malnutrition. The accuracy of MST or other nutrition-related parameters to detect malnutrition in ambulatory patients with CKD stages 4–5 without KRT has not been evaluated. Methods: A single site retrospective audit of outpatient records from May 2020 to March 2025 was conducted. Patients with eGFR < 25 mL/min/1.73 m² without KRT who had both MST and a 7-point Subjective Global Assessment (SGA) within 7 days were included. Sensitivity, specificity, and ROC-AUC analyses compared nutritional parameters against SGA-defined malnutrition. Nutritional parameters tested included MST, hand grip strength, upper gastrointestinal symptom burden, poor appetite and a combination of some of these parameters. Results: Among 231 patients (68.8% male, median age 69 years, median eGFR 15), 29.9% were at risk of malnutrition (MST ≥ 2) and 33.8% malnourished (SGA ≤ 5). All potential screening tools had AUC ranging from 0.604 to 0.710, implying a poor-to-moderate discriminator ability to detect malnutrition. Combining HGS ≤ 29.5 kg or MST ≥2 demonstrated high sensitivity (95.5%) and negative predictive value (93.3%), but low specificity (33.3%) for detecting malnutrition, indicating this approach is effective for ruling out malnutrition but may over-identify at-risk individuals. Conclusions: MST and other tested tools showed limited overall accuracy to identify malnutrition. Using combined nutritional markers of HGS or MST score was the most sensitive tool for detecting malnutrition in this advanced CKD without KRT population. Full article

Background and Objectives: Adverse clinical outcomes are associated with malnutrition and frailty, which are highly prevalent among hospitalized older patients. This study aimed to evaluate their predictive value for the duration of hospitalization, short-term survival, and rehospitalization of patients admitted to internal medicine wards. Materials and Methods: This prospective cohort study included 134 acutely ill patients aged ≥50 years who were hospitalized in an internal medicine department and evaluated within the first 48 h of admission. Nutritional status was evaluated using the Mini nutritional assessment–short form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty was evaluated using the FRAIL scale and Clinical Frailty Scale (CFS). The primary outcomes were prolonged hospitalization (>10 days), mortality, and rehospitalization at 3 and 6 months post-discharge. Results: According to MNA-SF, 33.6% of patients were malnourished; 44% had nutritional risk per NRS-2002, and 44.8% were malnourished per GLIM. Frailty prevalence was 53.7% (FRAIL) and 59% (CFS). Malnutrition defined by all three scales (MNA-SF, NRS-2002, GLIM) was significantly associated with prolonged hospitalization (p = 0.043, 0.014, and 0.023, respectively), increased rehospitalization at both 3 months (p < 0.001) and 6 months (p < 0.001). Mortality was also significantly higher among malnourished patients. Higher CFS scores and low handgrip strength were additional predictors of adverse outcomes (p < 0.05). In multivariable analysis, GLIM-defined malnutrition and CFS remained independent predictors of rehospitalization and mortality. Conclusions: Frailty and malnutrition are highly prevalent and independently associated with prolonged hospital stay, short-term rehospitalization and mortality. Routine screening at admission may facilitate early identification and guide timely interventions to improve patient outcomes. These findings might guide hospital protocols in aging health systems and support the development of standardized geriatric care pathways. Full article

Background: Malnutrition and cancer-related fatigue (CRF) are prevalent in cancer patients, significantly impacting prognosis and quality of life. Oral nutritional supplements (ONSs) enriched with protein and ω-3 fatty acids may improve nutritional status and mitigate CRF. This study evaluates the effects of a high-protein, fish oil-enriched ONS (FOHP-ONS) on nutritional intake, body composition, fatigue, and quality of life in malnourished cancer patients. Methods: Cancer patients with malnutrition or inadequate food intake received 8 weeks of FOHP-ONS (2 cans/day, providing 4.2 g/day of ω-3 fatty acids). Dietary intake, body weight, handgrip strength, serum biochemical markers, nutritional status (PG-SGA), fatigue (BFI-T), and quality of life (EORTC QLQ-C30) were assessed at baseline, week 4, and week 8. Results: Of the 33 enrolled patients, 30 completed the study. Energy and protein intake significantly increased (p < 0.05), and body BMI and handgrip strength showed significant improvements (p < 0.05), while muscle mass did not change significantly. Nutritional status, assessed by PG-SGA, improved, with the proportion of severely malnourished patients (Stage C) decreasing from 46.7% to 13.3%, and moderately malnourished patients (Stage B) improving to well-nourished status (Stage A) from 10.0% to 30.0% (p < 0.001). Serum albumin levels increased significantly (p < 0.05), while fasting blood glucose significantly decreased (p < 0.05). Additionally, triglyceride levels significantly decreased (p < 0.05), while total cholesterol and LDL-C showed a downward trend. Cancer-related fatigue scores improved across all domains (p < 0.05), and quality of life significantly increased, particularly in physical and role functioning (p < 0.05). Conclusions: FOHP-ONS supplementation improved nutritional intake, body composition, and muscle strength while alleviating CRF and enhancing quality of life in malnourished cancer patients. These findings support its potential role in nutritional intervention for malnourished cancer patients. Full article

Background: Malnutrition is associated with adverse clinical and economic outcomes. We recently reported that the hospital mortality rate in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected inpatients was higher in malnourished patients than in those without malnutrition. The present study aimed to determine if SARS-CoV-2-infected inpatients who received oral nutrition supplementation (ONS) had improved survival. We performed a retrospective cohort study including 37,215 adults (aged 18 and older) admitted with COVID-19 to five Johns Hopkins–affiliated hospitals between 1 March 2020, and 31 March 2023. Malnutrition risk was initially screened using the Malnutrition Universal Screening Tool (MUST), with cases subsequently confirmed by registered dietitians via a standardized, validated assessment protocol. Logistic regression analysis predicting hospital mortality examined the association of ONS with hospital survival in SARS-CoV-2-infected inpatients, incorporating covariates and weights for ONS receipt. Results: Malnutrition was an independent predictor of higher hospital mortality from COVID-19 illness. The prevalence of malnutrition among adult inpatients with SARS-CoV-2 infection in our cohort was 15.22%. Inpatient adults with moderate or severe malnutrition in the context of acute illness or injury who were given ONS had lower odds of inpatient mortality (moderate OR = 0.72, 95% CI 0.62–0.85; severe OR = 0.76, 95% CI 0.67–0.87; both p < 0.001). Overweight and obese patients who received ONS had higher odds of inpatient mortality (overweight OR = 1.15, 95% CI 1.08–1.22, p < 0.0001; obese OR = 1.08, 95% CI 1.01–1.14, p = 0.02, respectively). For inpatients who were underweight, receiving ONS was protective against inpatient mortality (OR = 0.78, 95% CI 0.68–0.88, p = 0.0001). Thus, among adult inpatients with SARS-CoV-2 infection, malnourished and underweight individuals appeared to experience improved survival when provided with oral nutritional supplements (ONS), whereas overweight or obese patients remain at an elevated risk of mortality. The timing of ONS receipt in hospitalized patients with SARS-CoV-2 influenced mortality. Patients who had earlier time to ONS had 13% lower odds of inpatient mortality (OR = 0.87, 95% CI 0.79–0.97, p = 0.0105). Conclusions: In a cohort of SARS-CoV-2 adult inpatients, those with confirmed malnutrition receiving oral nutrition supplements had a higher likelihood of hospital survival. This is the first study demonstrating an association of oral nutrition intervention with reduced hospital mortality in malnourished SARS-CoV-2-infected adults. Full article

Background/Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease frequently accompanied by comorbid conditions that contribute to disability and worsen long-term outcomes. Among these, malnutrition and osteosarcopenia remain under-recognised. This cross-sectional study aimed to assess the prevalence of malnutrition and osteosarcopenia among elderly women with RA and explore the clinical impact of these conditions. Methods: Sixty-five women over 65 years with RA were evaluated using Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and EWGSOP2-based assessments for sarcopenia; bone status was measured by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and three-dimensional DXA (3D-DXA). Results: Malnutrition was identified in 49.2% and osteosarcopenia in 52.3% of participants. A significant bidirectional association was observed: malnourished patients had higher rates of osteosarcopenia (65.6% vs. 34.4%; p < 0.05), and osteosarcopenic patients were more frequently malnourished (61.8% vs. 39.1%; p < 0.05). Both conditions were associated with older age, lower body mass index (BMI), impaired muscle parameters, and reduced bone mineral density. Malnourished and osteosarcopenic patients reported worse fatigue and lower physical quality of life, despite similar inflammatory activity. Significant correlations were found between muscle mass indices and bone quality metrics assessed by 3D-DXA. These findings highlight a substantial burden of malnutrition and osteosarcopenia in elderly women with RA, even with well-controlled disease despite similar inflammatory activity (mean Disease Activity Score 28: 2.8 ± 1.0; 43.1% in remission. Conclusions: There is a substantial burden of malnutrition and osteosarcopenia in elderly women with RA that support the integration of systematic nutritional and musculoskeletal screening into routine care. Future studies should evaluate age- and disease-specific mechanisms and assess the benefit of multidisciplinary strategies to prevent frailty and improve long-term outcomes. Full article

Background/Objectives: Loop diuretics are among the most commonly used drugs in patients with heart failure with reduced ejection fraction (HFrEF). Higher doses of these diuretics are associated with poorer clinical status and may contribute to malnutrition. The study aims to assess the relationship between the use of high-dose loop diuretics and nutritional status in patients with HFrEF. Methods: The study included 353 hospitalized patients with HFrEF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Geriatric Nutritional Index (GNRI), and the CONtrolling NUTritional status (CONUT). Patients were divided into three groups according to the daily dose of loop diuretics (defined as furosemide equivalent = 1 × furosemide dose and 2 × torsemide dose): low dose (LD), 40 mg/day or no treatment; medium dose (MD), 41–160 mg/day; or high dose (HD), >160 mg/day. Results: Of the evaluated patients, the mean MNA score was 23.31 ± 2.93 points, and 49.8% were at risk of malnutrition or malnourished. According to the MNA, patients in HD and MD groups had worse nutritional status than the LD group, similarly according to the GNRI. For CONUT, the differences were significant between all groups: nutritional status was the worst in the HD group, intermediate in the MD group, and the best in the LD group. Conclusions: The intake of loop diuretics, especially in high doses, correlates with an elevated risk of malnutrition in patients with HFrEF independently of sex, age, NYHA class, and left ventricular ejection fraction. Full article

Objectives: To describe the results of nutritional and morphofunctional assessment in a cohort of adults with cystic fibrosis; to evaluate differences in nutritional status between patients with and without exocrine and/or endocrine pancreatic involvement. Methods: Cross-sectional study: A cohort of adults with cystic fibrosis evaluated in a multidisciplinary unit was analyzed. Pancreatic status was examined, and malnutrition was diagnosed according to GLIM criteria. Morphofunctional assessment consisted of nutritional ultrasound, bioelectrical impedance, handgrip dynamometry, and anthropometry. Qualitative variables are expressed as n (%), quantitative variables as median (IQR). For group comparisons, Fisher’s exact test was used for qualitative variables and the non-parametric median comparison test for quantitative variables. Results: n = 101 participants were recruited, of whom 44 (43.6%) were women. Median age was 33 (25–40.5) years. A total of 64 participants (63.4%) had exocrine pancreatic insufficiency (EPI), 44 (43.6%) had endocrine pancreatic insufficiency, and 28 (27.7%) had cystic fibrosis-related diabetes (CFRD). Median BMI was 23.4 (20.1–24.89) kg/m². A total of 48 patients (47.5%) were malnourished. Males with EPI had a higher prevalence of undernourishment than those without (56.4% vs. 16.7%, p = 0.005), but not women. CFRD patients displayed no differences in morphofunctional assessment. Conclusions: Almost half the sample was undernourished using GLIM criteria. Males with exocrine pancreatic insufficiency had worse nutritional status. Endocrine pancreatic involvement did not affect nutritional status. Full article

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized approach for assessing the nutritional status of patients and demonstrate strong predictive value for the prognosis of patients with gastric cancer. However, these criteria do not incorporate indicators of adipose tissue metabolic activity, which may reflect pro-tumor microenvironmental factors. This study investigated the combined predictive value of malnutrition, defined by the GLIM criteria, and preoperative adipose tissue ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake for recurrence-free survival (RFS) in patients with gastric cancer following radical surgery. Methods: A total of 105 patients were retrospectively enrolled and classified into malnourished and non-malnourished groups based on the GLIM criteria. Preoperative ¹⁸F-FDG positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) was used to measure the mean standardized uptake value (SUVmean) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The predictive values of these indicators for RFS in patients with gastric cancer were assessed. Results: Multivariate survival analysis was used to identify GLIM-defined malnutrition (p = 0.020) and increased preoperative VAT SUVmean (p = 0.042) as independent risk factors for RFS. The combined analysis revealed that patients with both malnutrition and a high preoperative VAT SUVmean had the poorest RFS (HR = 18.41, p < 0.001). The predictive model integrating GLIM criteria and VAT SUVmean outperformed the GLIM criteria alone. Conclusions: This study demonstrated that combining malnutrition defined by the GLIM criteria with preoperative visceral adipose tissue ¹⁸F-FDG uptake optimizes recurrence risk stratification and exhibits superior prognostic predictive efficacy compared to using the GLIM criteria alone. This approach provides new insights into individualized prognostic assessment and intervention strategies. Full article

Background: Preconception diet and nutritional status are important determinants of reproductive and pregnancy health. As a comprehensive evaluation, this paper describes harmonization of diet data across multiple cohorts including over 50,000 participants and the differences between them. This information may be useful for developing targeted strategies to improve women’s diet prior to pregnancy for optimal prenatal health outcomes. Methods: The Preconception Period Analysis of Risks and Exposures influencing health and Development (PrePARED) consortium incorporates studies covering the preconception period and includes both couples planning pregnancy and studies covering the reproductive period but not focused on pregnancy. We harmonized data on 56,520 participants from seven cohort studies that collected data during the preconception period. We generated data on diet quality according to the International Federation of Gynecology and Obstetrics (FIGO) nutrition checklist to examine diet quality measures across the cohorts and compare estimates of diet quality across studies. Four studies used food frequency questionnaires; one used a study-specific diet history; one used two 24 h dietary recalls; and one used a short series of general diet questions. Positive responses on the six FIGO questions were tallied to calculate a total diet quality score. Results: Cohort samples varied in terms of age; socioeconomic status; race; ethnicity; and geographic region. Across the cohorts, participants met a median of three or four of the FIGO criteria for diet quality; those most commonly met were recommendations for consumption of meat and protein, while those least commonly met were recommendations for limiting consumption of processed foods and snacks. There was greater variation in meeting recommendations for the consumption of fruits and vegetables; dairy; fish; and whole grains. The percentage meeting ≤ 2 criteria ranged from 6.4% (Coronary Artery Risk Development in Young Adults) to 40.4% (Bogalusa Heart Study). Discussion: There was wide variability across preconception cohort studies in the extent to which participants met FIGO dietary guidelines. Although studies were conducted in populations that were not likely to be malnourished, it was rare for women to meet all the preconception dietary recommendations. These findings illustrate a need for strategies to promote meeting dietary guidelines prior to conception to improve health outcomes. Full article

The association of frailty with body composition is complex. Frailty can be associated with significant anorexia and weight loss or overweight and obesity. In addition, the development of frailty leads to changes in muscle mass, muscle fibre type, and visceral fat. In older people with diabetes, frailty-induced body composition changes are clinically relevant as they may affect the metabolic profile of the frail person. The determinants of insulin resistance in frail older persons with diabetes include factors such as total body weight and the ratio of lean muscle mass to visceral fat mass. The predominant loss of insulin-resistant skeletal muscle fibres type II, in comparison to insulin-sensitive type I fibres, is another factor that modifies the overall insulin resistance of the individual. As a result, frailty appears to be a heterogeneous condition with variable insulin resistance across a metabolic spectrum. The spectrum spans from a sarcopenic obese frail phenotype at one end to an anorexic malnourished frail phenotype at the other end. The introduction of SGLT-2 inhibitors and GLP-1RA with novel anti-metabolic syndrome properties, not just glucose-lowering effect, should influence clinicians’ choice in frail older persons with diabetes. These agents are likely to be beneficial in patients at the sarcopenic obese end of the frailty spectrum, who should benefit most due to their high baseline risk of progression of metabolic syndrome, high insulin resistance, and the increased prevalence of cardiovascular risk factors. On the other hand, patients at the anorexic malnourished end of the frailty spectrum are likely not suitable for such therapy due to the regression of metabolic syndrome in this group of patients and the increased risk of further weight loss, dehydration, and hypotension. Full article

Malnutrition is one of the stronger predictors of morbi-mortality in end-stage kidney disease patients. Moreover, malnutrition in hospitalized patients severely affects multiple clinical outcomes, increasing the risk of complications. The Nutritional Risk Index and Geriatric Nutritional Risk Index are indexes used to evaluate the risk of malnutrition in hospitalized adults, which have been validated for dialysis patients and have been reported to be a validated prognostic index of nutrition-related morbidity and mortality. Objectives: The aim of this study is to evaluate the prevalence of early postoperative infections and their possible relationship with malnutrition in renal transplantation. Methods: We conducted a retrospective observational study, including all patients who received a kidney transplant, a total of 140, between January 2020 and December 2023, at a tertiary-level Spanish hospital. Results: The average GNRI was 110.1 ± 11.6, equivalent to adequate nutrition, and only 16.4% of patients were at risk of malnutrition. The mean NRI was 111.4 ± 11.8, equivalent to no risk of malnutrition, and only 17.2% of patients had a moderate-to-severe risk of malnutrition. A total of 30 patients (21.4%) required oral nutritional supplementation at discharge, especially modular protein supplements (86.7%), and 52 patients (37.1%) presented an infection during their stay. The most frequent infections were urinary tract infections (69.8% of the total). Malnutrition calculated by the GNRI or NRI correlated to a longer postoperative hospital stay and a higher rate of infectious complications (p < 0.05). Conclusions: Malnourished patients have a higher risk of early postoperative complications, including infection, and a longer hospitalization stay. The evaluation of nutritional status for the diagnosis and treatment of malnutrition is strongly recommended in ESKD patients on the waiting list for a kidney transplant. Full article