FEATURES OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: RELATION WITH INTERLEUKIN 6 AND FIBROBLAST GROWTH FACTOR 23
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i2.9210Keywords:
chronic kidney disease, nutritional status, protein-energy wasting, chronic inflammation, fibroblast growth factor 23, interleukin 6.Abstract
Malnutrition in patients with chronic kidney disease (CKD) is associated with an increased risk of morbidity and mortality. This study shows the association of markers of nutritional status, namely, the thickness of skinfold, with the marker of inflammation interleukin-6 and the phosphaturic hormone, fibroblast growth factor 23, which increases in CKD, which is associated with an increase in cardiovascular mortality.
The aim – to study the peculiarities of nutritional status of patients with CKD and to investigate the relations of FGF-23 and IL-6 with markers of nutritional status in CKD.
Material and Methods. The study involved 106 people, 47 women (44 %) and 59 men (56 %), age (49.6±13.9) years with CKD. We determined the level of albumin, IL-6, BMI, and the thickness of subscapular, triceps and abdominal skinfolds. The C-terminal fragment of FRF-23 was determined using a set of reagents for the immuno-enzyme analysis "Biomedica" and the STAT FAK 303 Plus machine.
Results and Discussion. The serum albumin level progressively decreased, reaching the minimum values at the terminal stage of renal failure (p<0.001). Among patients with CKD stage V malnutrition was observed in 31 % of patients, of whom 10 % had moderate malnutrition and 5 % had severe malnutrition. The skinfold thickness was reduced in parallel with the decline of GFR, gaining statistical significance at CKD stage III (p < 0.01) and reaching the lowest values ?at CKat CKD stage V. A saignificant negative relation between the skinfold thickness and FGF-23 concentration was found (r=-0.23; p<0.05). A saignificant negative relation was found between the skinfold thickness and the concentration of IL-6 (r=-0.23; p<0.05).
Conclusions. The skinfold thickness decreases with a decline in GFR and has an inverse relation with the level of IL-6, which indicates the nutritional properties of subcutaneous fat depots and the absence of proinflammatory effects of subcutaneous fat in patients with CKD.
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