Hypervolemia–malnutrition in renal failure: Is there a relationship?

Background: Malnutrition is very common in chronic kidney disease patients and it starts from predialytic stage. The purpose of our project is to investigate the relationship between volume and malnutrition. Materials and method: A total of 109 chronic kidney disease patients were included in the study. Three groups have been created in patients according to their subjective global assessment (SGA) and malnutrition situation; SGA A: well feed group, SGA B: mild to moderate malnutrition, SGA C: severe malnutrition. Anthropometric measurements of all patients have been made (Body mass index, mid arm circumference, mid arm muscle circumference, triceps skinfold thickness, biceps skinfold thickness). Albumin, total chlosterol, triglyceride, serum amino acid leves have evaluated in blood samples of all patients. 24 hour ambulatory blood pressure monitoring was made for all patients. Results: According to results average age of patients was 59.92 year and average GFR was 23.56 mL/min. 22.01 percent of patients was evaluated as SGA A and 77.98 percent of patients was evaluated as SGA B and C. We found negative correlation between albumin, body mass index, mid arm circumference, mid arm muscle circumference, triceps skinfold thickness measurements and SGA scores. At the same time a positive correlation was found between NTSBP (Night time systolic blood pressure) and SGA scores. Discussion: Malnutrition and hypervolemia are significant cardiovascular risk factors for chronic kidney disease patients. In this study we examine the relationship between malnutrition and hypervolemia in predialysis patients. This study was cross sectional and only ambulatory blood pressure measuring used as a volume parameter so cause and effect relationship between hypervolemia-malnutrition should not be inferred. This study should be taken into consideration because it’s the first study that examines the relationship between ambulatory blood pressure and malnutrition in prediyalisis patients. Also our data shows statistically significant relationship between amino acid levels and blood pressure parameters and this study is the first reported data in this topic.