INTRODUCTION. The purpose of this study was to evaluate in outpatients with different degree of CKD the prevalence of malnutrition (m) and modifications in the time using a novel score. METHODS:160 patients (p) with CKD at free diet were divided according to GFR calculated from MDRD: stage II n=23 (M 15 F 8 mean age 60±19 yrs); stage III n=69 (M 45 F 24 mean age 63±15 yrs); stage IV n=57 (M 36 F 21 mean age 71±16 yrs); stage V n=11 (M 7 F 4 mean age 70±10 yrs). For each p we considered: age, heart disease, C-reactive protein, albumin, lymphocytes, cholesterol, BMI, SGA and analysis of body composition derived from BIA: PA, FM, FFM, BCM, BCMI. The score used in this study is shown in table 1.
P were followed-up from at least 1 to 3 years.
RESULTS and CONCLUSIONS. At baseline, according to m score, the prevalence of m was: Score=0: stage II=35%, stage III=20%, stage IV=2%, stage V=0%; Score=1: stage II=43%, stage III=32%, stage IV=19%, stage V=9%; Score=2: stage II=9%, stage III=15%, stage IV=18%, stage V=9%; Score=3: stage II=4%, stage III=16%, stage IV=26%, stage V=36%; Score=4: stage II=9%, stage III=17%, stage IV=35%, stage V=46%. The percentage of subjects with CRP >1 were: stage II 13%, stage III 14%, stage IV 28%, stage V 36% with an high prevalence of cardiovascular disease. At the end of the follow up the prevalence of p with normal nutritional status and at risk of m decreased in all groups, mainly in IV and V stage, increasing the prevalence of p with light, moderate and severe m (p<.01) over time. Our results confirm the high prevalence of m in outpatients with CKD, with a high percentage of p at risk of m in stage II; our m score has proved to be an useful, simple and valid tool to identify not only malnourished patients but also those at risk of m.