Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of.

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Presentation transcript:

Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism Juan J. Carrero, Pharm, PhD, Fridtjof Thomas, Biostat, PhD, Kristóf Nagy, MD, PhD, Fatiu Arogundade, MD, PhD, Carla M. Avesani, RnD, PhD, Maria Chan, RnD, PhD, Michal Chmielewski, MD, PhD, Antonio C. Cordeiro, MD, PhD, Angeles Espinosa-Cuevas, RnD, PhD, Enrico Fiaccadori, MD, PhD, Fitsum Guebre-Egziabher, MD, PhD, Rosa K. Hand, RnD, PhD, Adriana M. Hung, MD, PhD, Talat A. Ikizler, MD, PhD, Lina R. Johansson, RnD, PhD, Kamyar Kalantar-Zadeh, MD, PhD, Tilakavati Karupaiah, RnD, PhD, Bengt Lindholm, MD, PhD, Peter Marckmann, MD, PhD, Denise Mafra, RnD, PhD, Rulan S. Parekh, MD, PhD, Jongha Park, MD, PhD, Sharon Russo, MD, Anita Saxena, MD, PhD, Siren Sezer, MD, PhD, Daniel Teta, MD, PhD, Pieter M. Ter Wee, MD, PhD, Cecile Verseput, RnD, PhD, Angela Y.M. Wang, MD, PhD, Hong Xu, MD, PhD, Yimin Lu, MD, PhD, Miklos Z. Molnar, MD, PhD, Csaba P. Kovesdy, MD, PhD Journal of Renal Nutrition Volume 28, Issue 6, Pages 380-392 (November 2018) DOI: 10.1053/j.jrn.2018.08.006 Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 Flow of studies through the different phases of the systematic review. 84 studies including maintenance dialysis patients resulted in a higher number of separate estimates given that some studies included cohorts of HD and PD patients and/or estimates from various countries. CKD, chronic kidney disease; ISRNM, International Society of Renal Nutrition and Metabolism; PEW, protein-energy wasting; SGA, subjective global assessment. Journal of Renal Nutrition 2018 28, 380-392DOI: (10.1053/j.jrn.2018.08.006) Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 PEW prevalence results reported from studies including kidney transplant (Tx), acute kidney injury (AKI), and nondialysis chronic kidney disease (CKD) stages 3-5 patients. CI, confidence interval; PEW, protein-energy wasting. Journal of Renal Nutrition 2018 28, 380-392DOI: (10.1053/j.jrn.2018.08.006) Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 Prevalence of PEW among patients undergoing maintenance dialysis worldwide reported from studies published during 2000-2014. Color gradation reflects PEW prevalence in all included studies from each country (weighted averages within countries). PEW, protein-energy wasting. Journal of Renal Nutrition 2018 28, 380-392DOI: (10.1053/j.jrn.2018.08.006) Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions

Figure 4 PEW prevalence results in studies including patients on maintenance dialysis, depicting reported prevalence of individual studies by country within region and marking in gray the interquartile range of the studies' reported PEW prevalence (i.e., 50% of the studies reported a prevalence within the highlighted area). See supplemental figures for expanded versions including confidence intervals (Germany and Korea have two studies each with prevalence too close to each other to discern as separate points in the figure). PEW, protein-energy wasting. Journal of Renal Nutrition 2018 28, 380-392DOI: (10.1053/j.jrn.2018.08.006) Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions