GLIM in chronic kidney disease: What do we need to know?

Silva, Maryanne Zilli Canedo; Cederholm, Tommy; Gonzalez, Maria Cristina; Lindholm, Bengt; Avesani, Carla María

doi:10.1016/j.clnu.2023.04.019

Cited by 5 publications

(6 citation statements)

References 28 publications

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“…Many humans become overweight and obese, and a low BMI does not accurately reflect malnutrition. RMM should be evaluated at all times for the phenotypic criterion in patients with CKD ( 19 , 45 , 46 ). In our study, the addition of HGS increased the sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Validity and applicability of the global leadership initiative on malnutrition criteria in non-dialysis patients with chronic kidney disease

Huang,

Wang,

Luo

et al. 2024

Front. Nutr.

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IntroductionThere are no standardized assessment criteria for selecting nutritional risk screening tools or indicators to assess reduced muscle mass (RMM) in the Global Leadership Initiative on Malnutrition (GLIM) criteria. We aimed to compare the consistency of different GLIM criteria with Subjective Global Assessment (SGA) and protein-energy wasting (PEW).MethodsIn this study, nutritional risk screening 2002 first four questions (NRS-2002-4Q), Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Mini-Nutritional Assessment Short-Form (MNA-SF) tools were used as the first step of nutritional risk screening for the GLIM. The RMM is expressed using different metrics. The SGA and PEW were used to diagnose patients and classify them as malnourished and non-malnourished. Kappa (κ) tests were used to compare the concordance between the SGA, PEW, and GLIM of each combination of screening tools.ResultsA total of 157 patients were included. Patients with Chronic kidney disease (CKD) stage 1–3 accounted for a large proportion (79.0%). The prevalence rates of malnutrition diagnosed using the SGA and PEW were 18.5% and 19.7%, respectively. The prevalence of GLIM-diagnosed malnutrition ranges from 5.1% to 37.6%, depending on the different screening methods for nutritional risk and the different indicators denoting RMM. The SGA was moderately consistent with the PEW (κ = 0.423, p < 0.001). The consistency among the GLIM, SGA, and PEW was generally low. Using the NRS-2002-4Q to screen for nutritional risk, GLIM had the best agreement with SGA and PEW when skeletal muscle index (SMI), fat-free mass index (FFMI), and hand grip strength (HGS) indicated a reduction in muscle mass (SGA: κ = 0.464, 95% CI 0.28–0.65; PEW: κ = 0.306, 95% CI 0.12–0.49).ConclusionThe concordance between the GLIM criteria and the SGA and PEW depended on the screening tool used in the GLIM process. The inclusion of RMM in the GLIM framework is important. The addition of HGS could further improve the performance of the GLIM standard compared to the use of body composition measurements.

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Section: Discussionmentioning

confidence: 99%

Validity and applicability of the global leadership initiative on malnutrition criteria in non-dialysis patients with chronic kidney disease

Huang,

Wang,

Luo

et al. 2024

Front. Nutr.

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“…PEW provides a broader understanding of CKD-related mechanisms, including the hypercatabolic pathway driven by uremic toxins and inflammation [6]. Given that the term malnutrition is preferred by the Global Leadership Initiative on Malnutrition (GLIM) and PEW in the context of CKD, we will use the term PEW/malnutrition [7].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Combined Nutrition and Exercise Interventions in Patients with Chronic Kidney Disease

de Geus,

Dam,

Visser

et al. 2024

Nutrients

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Combined nutrition and exercise interventions potentially improve protein-energy wasting/malnutrition-related outcomes in patients with chronic kidney disease (CKD). The aim was to systematically review the effect of combined interventions on nutritional status, muscle strength, physical performance and QoL. MEDLINE, Cochrane, Embase, Web of Science and Google Scholar were searched for studies up to the date of July 2023. Methodological quality was appraised with the Cochrane risk-of-bias tool. Ten randomized controlled trials (nine publications) were included (334 patients). No differences were observed in body mass index, lean body mass or leg strength. An improvement was found in the six-minute walk test (6-MWT) (n = 3, MD 27.2, 95%CI [7 to 48], p = 0.008), but not in the timed up-and-go test. No effect was found on QoL. A positive impact on 6-MWT was observed, but no improvements were detected in nutritional status, muscle strength or QoL. Concerns about reliability and generalizability arise due to limited statistical power and study heterogeneity of the studies included.

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“…Most patients with severe CKD meet both etiological criteria developed by the GLIM criteria because they frequently experience systemic inflammation and anorexia caused by the retention of uremic toxins. The prevalence of malnutrition diagnosed by GLIM was between 12 and 54.3%, depending on the stage of CKD, the population, and the combination of criteria used [ 15 ]. Although GLIM has been validated against various semi-gold standard parameters and represents a significant advancement in the diagnosis of malnutrition across various patient categories and clinical settings [ 16 ], studies are still relatively new and scarce.…”

Section: Introductionmentioning

confidence: 99%

“…Although GLIM has been validated against various semi-gold standard parameters and represents a significant advancement in the diagnosis of malnutrition across various patient categories and clinical settings [ 16 ], studies are still relatively new and scarce. Further research is needed on patients at different stages of CKD to fully comprehend its applicability and value in clinical practice [ 15 ]. This is because muscle mass and the three phenotypic criteria suggested by GLIM can be influenced in patients with fluid retention at an advanced stage of CKD, leading to an underestimation of malnutrition.…”

Section: Introductionmentioning

confidence: 99%

“…Body weight and BMI are also influenced, as many kidney failure patients suffer from obese sarcopenia that may be related to inflammation [ 17 ]. As a result, several studies recommended implementing GLIM as a complement to the diversity of methods and tools already used for the diagnosis of malnutrition in CKD, such as subjective global assessment (SGA) and malnutrition-inflammation score (MIS), which apply a set of composite scores to diagnose malnutrition [ 14 , 15 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Mapping the global research landscape on malnutrition for patients with chronic kidney disease: a visualization analysis

Shakhshir,

Vanoh,

Hassan

et al. 2023

J Health Popul Nutr

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Background Chronic kidney disease (CKD) is seen as a diverse disease and a primary contributor to global mortality. Malnutrition arises within chronic illness, which involves protein energy depletion and inadequate levels of essential nutrients. These factors increase the likelihood of death and the overall impact of the disease on affected individuals. Consequently, this study aims to utilize bibliometric and visual analysis to assess the current state of research, the latest advances and emerging patterns in the fields of CKD and malnutrition. Methods Extensive research was conducted using the Scopus database, which is the most authoritative database of research publications and citations, to focus on CKD research between 2003 and 2022, as indicated by title and author keywords. Then, within this vast collection of academic publications, a notable subset of articles was exclusively dedicated to investigating the relationship between CKD and malnutrition. Finally, we performed bibliometric analysis and visualization using VOSviewer 1.6.19 and Microsoft Excel 2013. Results Large global research between 2003 and 2022 resulted in 50,588 documents focused on CKD, as indicated by title and author keywords. In this extensive collection of scientific publications, a staggering portion of 823 articles is devoted exclusively to investigating the link between CKD and malnutrition. Further analysis reveals that this body of work consists of 565 articles (68.65%), 221 reviews (26.85%), and 37 miscellaneous entries (4.50%), which encompass letters and editorials. The USA was found to be the most productive country (n = 173; 21.02%), followed by Italy (n = 83; 10.09%), Sweden (n = 56; 6.80%), Brazil (n = 54; 6.56%) and China (n = 51; 6.20%). The most common terms on the map include those related to the topic of (a) malnutrition in hemodialysis patients and predicting factors; terms associated with the (b) impact of malnutrition on cardiovascular risk and complications in CKD patients; and terms related to the (c) dietary protein intake and malnutrition in CKD. Conclusions This study is the first of its kind to analyze CKD and malnutrition research using data from Scopus for visualization and network mapping. Recent trends indicate an increasing focus on protein-energy wasting/malnutrition in hemodialysis patients and predicting factors, dietary protein intake, and malnutrition in CKD. These topics have gained significant attention and reflect the latest scientific advances. Intervention studies are crucial to examining diet therapy's impact on patients with stages 1 to 5 CKD. We hope this study will offer researchers, dietitians and nephrologists valuable information.

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GLIM in chronic kidney disease: What do we need to know?

Cited by 5 publications

References 28 publications

Validity and applicability of the global leadership initiative on malnutrition criteria in non-dialysis patients with chronic kidney disease

Validity and applicability of the global leadership initiative on malnutrition criteria in non-dialysis patients with chronic kidney disease

The Impact of Combined Nutrition and Exercise Interventions in Patients with Chronic Kidney Disease

Mapping the global research landscape on malnutrition for patients with chronic kidney disease: a visualization analysis

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