Kidney Res Clin Pract. 2025 Nov 28. doi: 10.23876/j.krcp.25.112. Online ahead of print.
ABSTRACT
BACKGROUND: Protein-energy wasting (PEW) is a strong indicator of adverse outcomes such as all-cause death and cardiovascular events. Although this association has been established in dialysis patients, it has not been clearly demonstrated in those with non-dialysis-dependent chronic kidney disease (NDD-CKD). This study aimed to evaluate the association between PEW and all-cause death or cardiovascular events in patients with NDD-CKD.
METHODS: We investigated the association between PEW and adverse outcomes in patients with NDD-CKD through a prospective cohort study of 1,847 patients (median follow-up: 6.94 years). The definition of PEW followed the International Society of Renal Nutrition and Metabolism criteria: serum albumin <3.8 g/dL, body mass index <23.0 kg/m2, skeletal muscle mass <19.7 kg in women, <26.9 kg in men, and protein intake <0.6 g/kg/day.
RESULTS: During follow-up, 129 deaths and 264 composite outcomes (all-cause death or cardiovascular events) occurred. In Cox regression analysis, all-cause death and composite outcomes were significantly increased in patients with two or more PEW parameters. All-cause death was significantly increased in patients with two PEW parameters (hazard ratio [HR], 2.78; 95% confidence interval [CI], 1.61-4.08; p < 0.001) or ≥3 PEW parameters (HR, 3.78; 95% CI, 1.81-7.89; p < 0.001). Composite outcomes were also significantly increased in patients with two PEW parameters (HR, 2.16; 95% CI, 1.51-3.11; p < 0.001) or ≥3 PEW parameters (HR, 2.30; 95% CI, 1.30-4.07; p = 0.004).
CONCLUSION: PEW was a strong indicator of all-cause death and composite outcomes among NDD-CKD patients.
PMID:41342161 | DOI:10.23876/j.krcp.25.112