VW95MVKX
type: UserItem
resource: Admission kidney function is a strong predictor for the response to nutritional support in patients at nutritional risk
tagged: UserTag
  label: *Nutrition Surveys
tagged: UserTag
  label: *Nutritional Status
tagged: UserTag
  label: Abbott Nutrition. The institution of Z.Stanga received speaking honoraria and
tagged: UserTag
  label: Aged
tagged: UserTag
  label: Chronic kidney disease
tagged: UserTag
  label: Clinical outcomes
tagged: UserTag
  label: Desenvolvimento Humanitario. All other authors report no conflicts of interest.
tagged: UserTag
  label: Female
tagged: UserTag
  label: Glomerular Filtration Rate/physiology
tagged: UserTag
  label: Humans
tagged: UserTag
  label: Kidney function
tagged: UserTag
  label: Kidney/*physiology
tagged: UserTag
  label: Male
tagged: UserTag
  label: Malnutrition
tagged: UserTag
  label: Malnutrition/etiology
tagged: UserTag
  label: Middle Aged
tagged: UserTag
  label: Mr. St. Segerer was supported by a grant of the Fundacao Pesquisa e
tagged: UserTag
  label: Nutritional support
tagged: UserTag
  label: Outcome
tagged: UserTag
  label: PP00P3_150,531) and the Forschungsrat of the Kantonsspital Aarau (1410.000.058
tagged: UserTag
  label: Randomized trial
tagged: UserTag
  label: Renal Insufficiency, Chronic/*physiopathology
tagged: UserTag
  label: Renal function
tagged: UserTag
  label: Risk Factors
tagged: UserTag
  label: The results presented in this paper have not been published previously in whole
tagged: UserTag
  label: and 1410.000.044). The Institution of P.Schuetz has previously received
tagged: UserTag
  label: grant from the Swiss National Foundation to P.Schuetz (SNSF Professorship,
tagged: UserTag
  label: or part, except in abstract form.
tagged: UserTag
  label: research support from Neste Health Science, Abbott Nutrition and Fresenius Kabi.
tagged: UserTag
  label: unrestricted grant money unrelated to this project from Neste Health Science and

Admission kidney function is a strong predictor for the response to nutritional support in patients at nutritional risk
type: AcademicArticle
abstract: BACKGROUND: Patients with chronic kidney disease (CKD) are at substantial risk of malnutrition, which negatively affects clinical outcomes. We investigated the association of kidney function assessed at hospital admission and effectiveness of nutritional support in hospitalized medical patients at risk of malnutrition. METHODS: This is a secondary analysis of an investigator-initiated, randomized-controlled, Swiss multicenter trial (EFFORT) that compared individualised nutritional support with usual hospital food on clinical outcomes. We compared effects of nutritional support on mortality in subgroups of patients stratified according to kidney function at the time of hospital admission (estimated glomerular filtration rates [eGFR] <15, 15-29, 30-59, 60-89 and >/= 90 ml/min/1.73 m(2)). RESULTS: We included 1943 of 2028 patients (96%) from the original trial with known admission creatinine levels. Admission eGFR was a strong predictor for the beneficial effects of nutritional support in regard to lowering of 30-day mortality. Patients with an eGFR <15, 15-29 and 30-59 had the strongest mortality benefit (odds ratios [95%CI] of 0.24 [0.05 to 1.25], 0.37 [0.14 to 0.95] and 0.39 [0.21 to 0.75], respectively), while patients with less severe impairment in kidney function had a less pronounced mortality benefits (p for interaction 0.001). A similar stepwise association of kidney function and response to nutritional support was found also for other secondary outcomes. CONCLUSION: In medical inpatients at nutritional risk, admission kidney function was a strong predictor for the response to nutritional therapy. Initial kidney function may help to individualize nutritional support in the future by identification of patients with most clinical benefit. CLINICAL TRIAL REGISTRATION: Registered under ClinicalTrials.gov Identifier no. NCT02517476.
pages: 2762-2771
doi: 10.1016/j.clnu.2021.03.013
source: 33933742
creator: Person
author list: Person
is part of: Issue
  date: 2021-05-03
  volume: 40
  issue: 5
  is part of: Clin Nutr
    type: Journal
    issn: 1532-1983 (Electronic) 0261-5614 (Linking)

Person
given name: A.
surname: Bargetzi

Person
given name: N.
surname: Emmenegger

Person
given name: S.
surname: Wildisen

Person
given name: M.
surname: Nickler

Person
given name: L.
surname: Bargetzi

Person
given name: L.
surname: Hersberger

Person
given name: S.
surname: Segerer

Person
given name: N.
surname: Kaegi-Braun

Person
given name: P.
surname: Tribolet

Person
given name: F.
surname: Gomes

Person
given name: C.
surname: Hoess

Person
given name: V.
surname: Pavlicek

Person
given name: S.
surname: Bilz

Person
given name: S.
surname: Sigrist

Person
given name: M.
surname: Brandle

Person
given name: C.
surname: Henzen

Person
given name: R.
surname: Thomann

Person
given name: J.
surname: Rutishauser

Person
given name: D.
surname: Aujesky

Person
given name: N.
surname: Rodondi

Person
given name: J.
surname: Donze

Person
given name: Z.
surname: Stanga

Person
given name: B.
surname: Mueller

Person
given name: P.
surname: Schuetz