Background & aims
Malnutrition is common in older patients with advanced chronic kidney disease (CKD). This study investigates whether nutritional status is associated with 1-year mortality and CKD progression in this population.
Methods
Patients ≥65 years (eGFR 20 – 10 mL/min/1.73m2) were included from the observational prospective DIALOGICA study. Patients were classified as being at risk of malnutrition with a Mini Nutritional Assessment Short-Form (MNA-SF) score ≤11 and as having a normal nutritional status with scores ≥12. One-year mortality was defined as death (all-cause) occurring within 1-year and CKD progression as eGFR decline <10 mL/min/1.73m2 and/or initiation of kidney replacement therapy (KRT) within 1-year from inclusion. Associations between nutritional status and mortality were assessed using multivariable Cox proportional hazards models, associations between nutritional status and CKD progression were assessed using multivariable Fine-Gray models.
Results
610 patients were included (mean age 76.6±5.8 years, mean eGFR 14.8±3.1 mL/min/1.73m2), with 160 patients (26.2%) at risk of malnutrition. During follow-up, 55 patients (9.0%) died and 154 patients (25.2%) experienced CKD progression. Patients at risk of malnutrition had significantly higher 1-year mortality risk (adjusted hazard ratio or HR 1.88, 95% CI 1.08;3.25) but not significantly higher CKD progression risk (adjusted subdistributional-HR 1.06, 95% CI 0.71;1.59).
Conclusion
Older patients with advanced CKD and malnutrition risk face significantly higher 1-year mortality risk but not higher CKD progression risk. These findings may help identify vulnerable patients who are at high risk of early mortality who may benefit from dietary interventions.
Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Overview publication
| Title | Nutritional status, mortality and kidney disease progression in older patients with advanced chronic kidney disease. |
| Date | June 19th, 2026 |
| Issue name | Clinical nutrition ESPEN |
| Issue number | :103400 |
| DOI | 10.1016/j.clnesp.2026.103400 |
| PubMed | 42320566 |
| Authors | |
| Info | Van Buren M, Abrahams AC, van Oevelen M, Demirhan I, Mooijaart SP, van Jaarsveld BC, Emmelot-Vonk MH, Dam MT, Franssen C, Bos W, de Wit GA, van Diepen M, Dekker FW, Leurs P, van der Net JB, Cnossen TT, van der Muren S, Neradova A, van Jaarsveld BC, van Breda F, Eshuis M, Bunthof K, Ter Meulen CG, Ten Dam M, Konings C, van Eck van der Sluijs A, Logtenberg S, Severs D, Polinder-Bos HA, Boonstra AH, van der Leeuw J, Vermeeren YM, Hommes NH, van Buren M, Siezenga MA, Golüke N, Kallenberg MH, Hoogeveen EK, Kerckhoffs A, Cornelis T, Boorsma S, Bouwsma H, Michels WM, van Diepen M, Dekker FW, van den Dorpel R, Hoekstra B, Joosten J, Litjens E, Kramer AB, Kuijper A, Bosma RJ, Romijn M, Adema AY, Bontemps-Visser A, van Dam B, van der Meijden W, Boom H, van Kempen G, Klein H, Bos W, Snoep JD, Schuurmans M, Nauta FL, Franssen C, Diepenbroek A, Abrahams AC, Molenaar FM, Maanen ACD, Emmelot-Vonk MH, François K, Wauters I, Krekels M, Plum PF, de Wit GA |
| Keywords | CKD progression, Nutritional status, elderly, geriatric, mortality, older |
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