European Journal of Molecular & Clinical Medicine

Abstract

Among kidney failure patients, especially those on dialysis, malnutrition is associated with poor outcomes. Malnutrition is a multifactorial process, including inflammation, which can be measured by C-reactive protein (CRP). The objective is to evaluate the dynamics of CRP associated with nutritional status changes in kidney failure patients at initiation and after 3 months of dialysis. A prospective cohort study using a consecutive sampling method consisting of 40 kidney failure patients who received initial dialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January-March 2020. Nutritional status was evaluated with Subjective Global Assessment (SGA), and CRP was measured at the initial dialysis and after 3 months. All subjects received nutritional education at the beginning. Nutritional status was defined as well-nourished (WN, SGA A) and malnourished (MN, SGA B and C), then classified into 4 groups denoting nutritional changes: Group 1 (WN to WN), Group 2 (MN to WN), Group 3 (WN to MN), and Group 4 (MN to MN). ANOVA, paired t-test, and chi-square test (significance p<0.05) were used for statistical analyses. Subject’s mean age was 50.5±14.8 years old; 52.5% were male. Diabetes and obstructive nephropathy were the most frequent underlying diseases, both had a prevalence of 35%. At initiation, the prevalence of malnutrition was 77.5%; after 3 months, it was 70%. The highest proportion of Group 4 were female (62.5%) and those with diabetes (45.9%). Among all subjects, mean CRP decreased (9.4±32.3 mg/dL) after 3 months. While mean CRP based on nutritional changes, Group 2 had the highest reduction (18.8±26.8 mg/dL), and Group 3, CRP increased (17.5±17.0 mg/dL). C-reactive protein is negatively associated with nutritional status changes in kidney failure patients after 3 months of dialysis. Malnutrition was higher in female subjects and those with diabetes.