Many people with chronic kidney disease (CKD) face both obesity and malnutrition, but not all the causes have been clear. In 2022, researchers at the University of Bergen in Norway investigated the effects of prescription medications on CKD patients’ nutritional status. Learn more about what they did, what they found, and what it means.*

What they did

For the study, published in the Journal of Renal Nutrition, Helene Dahl, MS, RD, and colleagues collected data from 217 patients with CKD. Of these:

• 112 had pre-dialysis CKD stages 3-5, 
• 33 were on hemodialysis, and 
• 72 had kidney transplants. 

The researchers compared patients’ prescribed medication information to their nutritional status. Nutritional status was determined from nutrition-related bloodwork (i.e. albumin and hemoglobin) and body measurements including:

• Height, weight, and body mass index (BMI) 
• Mid-upper arm circumference (MUAC) 
• Skinfold thickness (SFT) in triceps
• Handgrip strength (HGS) 
• Waist circumference

What they found

Results of the evaluation showed that patients had negative nutrition outcomes as the number of medications increased, particularly in: 

• MUAC, 
• SFT triceps, 
• HGS, 
• Albumin, and 
• Hemoglobin. 

Moreover, medications that listed nausea as a side effect also created similar results. Medications causing dry mouth were associated with lower handgrip strength. 

Another concerning finding was the:

84% rate of polypharmacy (the use of 5-9 medications), and 37% excessive polypharmacy (the use of at least 10 medications).

There was also a high prevalence of overweight and obesity (62%), but a low percentage of underweight (1.4%). 

What it means

Medical professionals tend to focus on weight, height, and BMI to determine a patient’s nutritional status and leave out other relevant measurements of that status. A person need not be underweight to be malnourished. The study findings highlighted the need for more varied data to evaluate patients’ overall health.

The researchers also found that long medication lists may contribute to malnourishment in CKD patients. They suggest, “A wider assessment of nutritional status including measurements such as MUAC, SFT triceps, and HGS should be conducted regularly to identify potential challenges of nutritional status and address these accordingly in patients with CKD.”

*More prescriptions a patient has linked with poor nutritional status in those with CKD. (2022, September 9). Retrieved September 24, 2022, from https://www.healio.com/news/nephrology/20220909/more-prescriptions-a-patient-has-linked-with-poor-nutritional-status-in-those-with-ckd