Clinical Epidemiology and Global Health (Oct 2021)
Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: An evidence based systematic review and meta-analysis
Abstract
Background: Malnutrition is one of the most serious complications of chronic kidney disease due to its devastating consequences in terms of quality of life, morbidity, hospitalization and mortality. This study aims to evaluate the prevalence of malnutrition among chronic kidney disease patients globally and its contrast with India. Methods: Articles reporting the prevalence of malnutrition associated with CKD patients were retrieved from PubMed/Medline, ScienceDirect, Cochrane library & Google scholar. The quality assessment of studies was performed by using Newcastle-Ottawa scale. The pooled prevalence was reported with effect size considering the random effect model using comprehensive meta-analysis version 2.0. Results: The results from 61 observational studies containing 21119 patients are presented. The global prevalence of malnutrition associated with CKD was found to be 42.7%. The prevalence of malnutrition in peritoneal dialysis group was found to be (45.3%, 95%CI; 29.5–62.1) higher as compared to hemodialysis group (43.1%, 95% CI; 32.2–54.7) followed by non-dialysis group (38.5%, 95% CI; 24.0–55.3). The prevalence of malnutrition in India was found to be 56.7% (95% CI: 42.4–70.0%). Males were predominantly affected with malnutrition as compared to females. The prevalence in India was reported to be higher as compared to all the included countries, except Mexico and Jordan. Conclusions: Globally, India occupies the highest share of prevalence studies followed by Brazil. The geographical stratification of results revealed that the highest prevalence of malnutrition was observed in India except Mexico and Jordan. Given the high prevalence of malnutrition among CKD patients, evaluation of interventions for malnutrition with patient centered outcomes are warranted.
