50 - The Relationship Between Preexisting Malnutrition in Youth and Risk of Developing Chronic Kidney Disease
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 50 Publication Number: 50.253
Andrew M.. South, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Kayla McMillan, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
Graduate Student Wake Forest School of Medicine of Wake Forest Baptist Medical Center Winston-Salem, North Carolina, United States
Background: Malnutrition is highly prevalent in the United States, and globally it is responsible for 1 in 5 deaths in children under the age of five. Chronic kidney disease (CKD) is associated with an increased risk of malnutrition with up to 45% prevalence in youth with CKD. However, it is unknown if malnutrition itself can cause CKD in youth.
Objective: Determine if youth diagnosed with malnutrition have a greater risk of developing CKD compared to youth that do not have malnutrition.
Design/Methods: This is an ongoing electronic health record and bioinformatics-driven retrospective cohort study. Inclusion criteria were patients between the ages of 6 months and 18 years with a first occurrence of malnutrition defined by an ICD-10 code, or weight-for-height z- score or body mass index z-score < -2 in either an outpatient clinic encounter or an inpatient hospital encounter between 1/1/2015–12/30/2022. Exclusion criteria were premature birth (gestational age < 37 weeks or ICD-10 code), low birth weight (birth weight < 2500 g or ICD-10 code), congenital heart disease, liver disease, or CKD by ICD-10 code at index date. The malnutrition cohort will be matched to controls based on age, sex, and race. We will estimate the risk of CKD in our exposed cohort compared to controls using adjusted generalized linear models and Cox regression models.
Results: We have initially identified a total of 8878 patients meeting our inclusion and exclusion criteria for the exposed cohort. 41.6% were female, 54.6% were White or Caucasian race, 18.3% were Black or African American race, and 13.4% were Hispanic/Latino ethnicity.
Conclusion(s): We collected 8878 patients to build a cohort of patients with malnutrition. We will then analyze and assess the risk of developing CKD in these patients compared to a control population to determine if the risk of CKD is higher in patients with preexisting malnutrition. Additionally, we will try and determine the duration of malnourishment before any onset of damage to the kidney occurs. This will directly impact the way patients are identified as high risk for developing CKD and allow faster intervention to prevent clinical diagnosis of CKD later in life. Concurrently, we are designing an animal study to further assess the causality of malnutrition with CKD by studying what effect various timed nutritional restriction has on the kidney.
