Prevalence and associated factors of protein- energy wasting among patients with chronic kidney disease at Mulago hospital, Kampala-Uganda: a cross-sectional study

Lydia Namuyimbwa,Joel Okullo,Collins Atuheire,Robert Kalyesubula

doi:10.1186/s12882-018-0920-7

Lydia Namuyimbwa, Joel Okullo + Show 2 more

Open Access

https://doi.org/10.1186/s12882-018-0920-7

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Abstract

BackgroundChronic kidney disease (CKD) is global health concern and priority. It is the 12th leading cause of death worldwide. Protein Energy Wasting occurs in 20–25% of patients with chronic kidney disease and can lead to a high morbidity and mortality rate. We determined the prevalence of protein energy wasting and factors associated among patients with chronic kidney disease at Mulago National Referral Hospital, Kampala, Uganda.MethodsWe conducted a cross-sectional study recruiting 182 (89 non-CKD patients and 93 CKD patients) consecutively from the outpatient clinic and wards on New Mulago Hospital complex. We took anthropometric measurements including heights, weights, Triceps skin fold (TSF), Mid- Upper Arm circumference (MUAC), Body Mass Index (BMI) and Mid-arm muscle circumference (MAMC). Serum albumin levels and lipid profile levels were also obtained. Following consent of study participants, Data was collected using questionnaires and analyzed using STATA 14.1. Percentages, frequencies, means, medians, standard deviation and interquartile range were used to summarise data. Crude and adjusted binary logistic regression was performed to assess unadjusted and adjusted effect measures of protein energy wasting due to several factors. Stratification by CKD status was performed during the analysis to minimize confounding.ResultsThe median age for CKD patients was 39 years compared to 27 years for non-CKD participants (p < 0.001). The prevalence of protein energy wasting (PEW) was 68.6% in this study with 47.3 and 21.3% among CKD and non-CKD participants respectively. Factors which were associated with PEW included CKD age between 18 and 24, being single, catholic religion, CKD stage 4, Hb < 11.5 g/dl and LDL > 160 mg/dl.ConclusionProtein energy Wasting is prevalent among patients with chronic kidney disease and clinicians should routinely screen for it during patient care.

Highlights

Chronic kidney disease (CKD) is global health concern and priority
The median age for CKD patients was 39 years compared to 27 years for non-CKD participant (p < 0.001) as shown in Table 1 at the end of the document
The results obtained from this study showed that Protein -energy wasting (PEW) was present in 47.3% (44/93) of the CKD patients compared to 21.3% (19/89) of the participants without CKD

Summary

Introduction

Chronic kidney disease (CKD) is global health concern and priority It is the 12th leading cause of death worldwide. We determined the prevalence of protein energy wasting and factors associated among patients with chronic kidney disease at Mulago National Referral Hospital, Kampala, Uganda. Chronic kidney disease being prevalent in Uganda (15.2%), it is important to study the nutrition status of CKD patients so that PEW can be diagnosed early, managed and prevented by clinicians during patient care. Protein energy wasting (PEW) among patients with CKD at Mulago Hospital and Uganda at large has not been characterized. This creates a gap in the nutritional management of these patients due to lack of baseline data. We determined the prevalence of PEW and associated factors among patients with chronic kidney disease at Mulago hospital, using a cross sectional study

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