Effect of Underlying Renal Disease on Nutritional and Metabolic Profile of Older Adults with Reduced Renal Function

Abstract

BackgroundChronic kidney disease is a common condition in the general population, particularly among older adults. Renal impairment is in turn associated with metabolic and nutritional derangements and with increased risk of cardiovascular disease.AimTo compare the metabolic, nutritional, and cardiovascular impact of reduced kidney function between patients with and without known renal disease.Materials and MethodsWe enrolled consecutive outpatients (age ≥65 years) with reduced renal function who were divided into two groups: Group A with history of renal disease and Group B with unknown renal disease. Metabolic and nutritional parameters, including involuntary body weight loss (BWL) in the previous 6 months, mineral metabolism, inflammatory indices, and left ventricular mass index (LVMI), were evaluated.ResultsA total of 76 patients were enrolled. Group A (n = 39, M: 24, F: 15) showed greater BWL with a significant reduction of 25-hydroxyvitamin D, transferrin, cholinesterase, albumin, and LVMI with respect to Group B (p < 0.01). Conversely, Group B (n = 37, M: 23, F: 14) showed significantly increased intact parathyroid hormone, total cholesterol, low-density lipoprotein, triglycerides, and C-reactive protein when compared to Group A (p < 0.05).ConclusionThe positive history of renal disease may negatively impact on several metabolic and nutritional parameters related to increased cardiovascular risk among older adults.

Estimated Glomerular Filtration Rate in Chronic Kidney Disease: A Critical Review of Estimate-Based Predictions of Individual Outcomes in Kidney Disease

“…In addition, cystatin C-based formulae may obviate the need for race-based correction and may more accurately reflect actual GFR in the context of sarcopenia [18]. This may be especially important in the elderly where functional renal decline may be associated with a complex change in metabolic profile [19] including weight loss and changes in serum albumin, C-reactive protein, and a host of other important parameters.…”

Tabebuia impetiginosa: A Comprehensive Review on Traditional Uses, Phytochemistry, and Immunopharmacological Properties

“…LTB 4 , a pro-inflammatory lipid mediator, is synthesized from arachidonic acid, expressed on many inflammatory and immune cells, and is a powerful chemokine that promotes migration of macrophages and neutrophils to tissues [ 46 ]. T. impetiginosa can also inhibit the proinflammatory cytokines interleukin (IL)-1β and IL-6 [ 15 , 47 ]. IL-1β has an important homeostatic function; however, overproduction of IL-1β can result in pathophysiological changes related to pain and inflammation [ 48 ].…”

“…Likewise, IL-6 is a pro-inflammatory mediator with pleiotropic effects on immune response, inflammation, and hematopoiesis, but excessive production of IL-6 can cause various diseases [ 49 ]. In addition, the mRNA expressions of IL-1β and inflammatory genes inducible NO synthase (iNOS) and cyclooxygenase (COX)-2 were markedly decreased when treated with T. impetiginosa [ 8 , 15 , 28 , 47 ]. Information gained from in vitro and in vivo models provided insights to other researchers for further investigation.…”