LI Xueqin , CHEN Chongcheng , LUO Yan , WANG Fang , ZHOU Xueli , ZHOU Qin , WANG Hui , MA Dengyan
  • Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
MA Dengyan, Email: mdy5104@163.com
Chronic kidney disease; Nutritional Risk Screening 2002; malnutrition; risk factors; prediction model
10.7507/1002-0179.202212048
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Objective  To investigate the nutritional status of hospitalized patients with chronic kidney disease (CKD), analyze the influencing factors, and construct a predictive model to provide a localized theoretical basis and more convenient risk prediction indicators and models for clinical nutrition support and intervention treatment of CKD patients in China. Methods  Convenience sampling was used to select hospitalized CKD patients from Department of Nephrology, West China Hospital, Sichuan University, from January to October 2019. General information questionnaires, the Nutritional Risk Screening 2002 scale, and the Huaxi Emotional-distress Index questionnaire were used for data collection. Single factor analyses and multiple logistic regression analysis were conducted to explore the risk factors for malnutrition in CKD hospitalized patients. A predictive model was established and evaluated using receiver operating characteristic (ROC) curve analysis and bootstrap resampling. Results  A total of 1059 valid copies of questionnaires were collected out of 1118 distributed. Among the 1059 CKD hospitalized patients, 207 cases (19.5%) were identified as having nutritional risk. The multiple logistic regression analysis showed that CKD stage [odds ratio (OR)=1.874, 95% confidence interval (CI) (1.631, 2.152), P<0.001], age [OR=1.015, 95%CI (1.003, 1.028), P=0.018], and the Huaxi Emotional-distress Index [OR=1.024, 95%CI (1.002, 1.048), P=0.033] were independent risk factors for malnutrition in CKD hospitalized patients, while serum albumin [OR=0.880, 95%CI (0.854, 0.907), P<0.001] was an independent protective factor. The evaluation of the multiple logistic regression analysis predictive model showed a concordance index of 0.977, standard deviation of 0.021, and P<0.05. The area under the ROC curve was 0.977. Conclusions  The prevalence of malnutrition is relatively high among CKD hospitalized patients. CKD stage, age, psychological status, and serum albumin are influencing factors for malnutrition in CKD hospitalized patients. The multiple logistic regression model based on the above indicators demonstrates good predictive performance and is expected to provide assistance for early nutritional intervention to improve the clinical outcomes and quality of life for CKD patients with malnutrition in China.

Citation： LI Xueqin, CHEN Chongcheng, LUO Yan, WANG Fang, ZHOU Xueli, ZHOU Qin, WANG Hui, MA Dengyan. Risk factor analysis and prediction model construction for malnutrition in chronic kidney disease inpatients. West China Medical Journal, 2023, 38(7): 1014-1020. doi: 10.7507/1002-0179.202212048 Copy

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