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- Title
Relationship between nutritional status and the glomerular filtration rate: Results from the MDRD Study.
- Authors
Kopple, Joel D.; Greene, Tom; Chumlea, W. Cameroon; Hollinger, Donna; Maroni, Bradley J.; Merrill, Donna; Scherch, Laura K.; Schulman, Gerald; Wang, Shin-Ru; Zimmer, Gail S.
- Abstract
Relationship between nutritional status and the glomerular filtration rate: Results from the MDRD Study. Background. The relationship between the protein-energy nutritional status and renal function was assessed in 1785 clinically stable patients with moderate to advanced chronic renal failure who were evaluated during the baseline phase of the Modification of Diet in Renal Disease Study. Their mean ± SD glomerular filtration rate (GFR) was 39.8 ± 21.1 mL/min/1.73 m2. Methods. The GFR was determined by 121I-iothalamate clearance and was correlated with dietary and nutritional parameters estimated from diet records, biochemistry measurements, and anthropometry. Results. The following parameters correlated directly with the GFR in both men and women: dietary protein intake estimated from the urea nitrogen appearance, dietary protein and energy intake estimated from dietary diaries, serum albumin, transferrin, percentage body fat, skinfold thickness, and urine creatinine excretion. Serum total cholesterol, actual and relative body weights, body mass index, and arm muscle area also correlated with the GFR in men. The relationships generally persisted after statistically controlling for reported efforts to restrict diets. Compared with patients with GFR > 37 mL/min/1.73 m2, the means of several nutritional parameters were significantly lower for GFR between 21 and 37 mL/min/1.73 m2, and lower still for GFRs under 21 mL/min/1.73 m2. In multivariable regression analyses, the association of GFR with several of the anthropometric and biochemical nutritional parameters was either attenuated or eliminated completely after controlling for protein and energy intakes, which were themselves strongly associated with many of the nutritional parameters. On the other hand, few patients showed evidence for actual protein-energy malnutrition. Conclusions. These cross-sectional findings suggest that in patients with...
- Subjects
NUTRITION; GLOMERULAR filtration rate; CHRONIC kidney failure
- Publication
Kidney International, 2000, Vol 57, Issue 4, p1688
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.00014.x