PD391 - RELATIONSHIP BETWEEN FLUID STATUS, MALNUTRITION, AND PHYSICAL FUNCTION IN CHRONIC KIDNEY DISEASE: AN OBSERVATIONAL POOLED ANALYSIS STUDY

PD391

RELATIONSHIP BETWEEN FLUID STATUS, MALNUTRITION, AND PHYSICAL FUNCTION IN CHRONIC KIDNEY DISEASE: AN OBSERVATIONAL POOLED ANALYSIS STUDY

N. T. Bellafronte^1,*, T. R. Chagas¹, J. D. C. M. Rodrigues², J. P. N. Gimenes³, H. Holland³, R. T. Biaggio⁴, P. G. Chiarello⁵, N. T. Bellafronte¹

¹Nutrition, ²Clinical Hospital Complex, Federal University of Paraná, Curitiba, ³Ribeirao Preto Medical School, ⁴Regional Blood Center of Ribeirão Preto, ⁵Health Sciences, University of Sao Paulo, Ribeirão Preto, Brazil

Rationale: Fluid shifts may promote hyper-catabolism and induce inflammation, leading to nutritional and functional decline. Thus, in individuals with chronic kidney disease (CKD), we investigated how fluid status relates to malnutrition and physical function.

Methods: Bioelectrical impedance vector analysis (BIVA) was applied to assess fluid status and total sample was stratified in dehydrated (DH) and normo-hyperhydrated (NH-HH) groups, which were compared. Muscle and adiposity-related measurements were assessed. Muscle strength was evaluated by hand-grip strength. Malnutrition, low muscle strength, sarcopenia and sarcopenic obesity were diagnosed. Correlation and regression analysis verified association between variables. Hotelling's T2 test assessed differences between mean impedance vectors.

Results: Of 362 individuals, 254 were DH and 108 were NH-HH. DH group presented lower muscle and fat mass (p < 0.05). Differences in malnutrition, sarcopenia and sarcopenic obesity prevalence between groups were dependent on definition for muscle mass impairment: applying low calf circumference, DH individuals presented 2.53, 2.58 and 3.27 higher risk for malnutrition, sarcopenia and sarcopenic obesity (p<0.05), respectively. Low HGS was present in 41% and 27% of DH and NH-HH groups (p=0.000). DH status likely lowered HGS by 2kgs (ꞵ = -2.01; p=0.059), with a 1.75 odds ratio for low muscle strength (p=0.070) as compared to NH-HH status. BIVA revealed significant differences in the confidence ellipses for presence and absence of conditions diagnosed (malnutrition, sarcopenia and sarcopenic obesity).

Conclusion: In CKD, dehydration appears to be associated with poorer muscle strength. Associations between fluid balance and malnutrition, sarcopenia, and sarcopenic obesity are dependent on the muscle mass parameter and cutoff applied.

Disclosure of Interest: None declared