Literature Review: Correlation of decreased glomerular filtration rate to malnutrition risk in pre-dialysis chronic kidney disease patients

Yenny Darmawaty Pangaribuan* -  Dietitian Profession Study Program, Faculty of Health Sciences, Brawijaya University, Indonesia
Inggita Kusumastuty -  Department of Nutrition, Faculty of Health Sciences, Brawijaya University, Indonesia

Supp. File(s): Publication Ethics Copyright Statement Covering Letter
Chronic kidney disease (CKD) is a condition characterized by a decreased glomerular filtration rate (GFR), which can cause the breakdown of protein reserves, resulting in malnutrition. This study aimed to determine the mechanism underlying the relationship between decreased GFR and the risk of malnutrition in pre-dialysis CKD patients.  Scoping review method using PubMed, ScienceDirect, and SpringerLink databases with the criteria of articles published from 2014 to 2024 and using RCTs or cross-sectional studies. Relevant articles were selected through the PRISMA method. The results showed that a decrease in GFR was strongly associated with malnutrition in pre-dialysis CKD through three main mechanisms: increased protein catabolism, decreased serum creatinine/cystatin C ratio, and increased number and diversity of drug prescriptions. Malnutrition due to changes in GFR can be observed through BMI, MUAC, muscle and fat mass, and handgrip strength. In conclusion, the lower the GFR, the higher the risk of malnutrition in pre-dialysis CKD and the lower the BMI value and MUAC size, reduced muscle mass and fat, and decreased handgrip strength and worsening kidney function, as indicated by the lower GFR.

Supplement Files

Keywords : Protein catabolism, pre-dialysis CKD, serum creatinine ratio, cystatin C, risk of malnutrition

  1. Adrianto, Y., Hustrini, N. M., Kresnawan, T., Amelia, A. E., & Hudayani, F. (2021). The Relationship of Subjective Global Assessment (SGA) with Energy Intake, Protein, Hand Grip Strength and Body Mass Index in Chronic Kidney Disease (CKD) Patients with Continuous Ambulatory Peritoneal Dialysis (CAPD). Jurnal Penyakit Dalam Indonesia, 8(4), 5. https://doi.org/10.7454/jpdi.v8i4.628
  2. Anggraini, D., & Adelin, P. (2023). Correlation between Anthropometric Measurement and Kidney Function in the Elderly to Detection of Chronic Kidney Disease. Indonesian Journal of Clinical Pathology and Medical Laboratory, 29(3), 245–249. https://doi.org/10.24293/IJCPML.V29I3.2019
  3. Dahl, H., Sandblost, S. R. T., Welland, N. L., Sandnes, K., Sekse, I., Sæle, K., Marti, H. P., Holst, L., & Dierkes, J. (2022). Medication Prescription, Common Side-effects, and Nutritional Status are Associated in Patients With Chronic Kidney Disease. Journal of Renal Nutrition, 32(5), 520–528. https://doi.org/10.1053/J.JRN.2021.10.008
  4. Dubey, A. K., Sahoo, J., Vairappan, B., Haridasan, S., Parameswaran, S., & Priyamvada, P. S. (2020). Correction of metabolic acidosis improves muscle mass and renal function in chronic kidney disease stages 3 and 4: a randomized controlled trial. Nephrology Dialysis Transplantation, 35(1), 121–129. https://doi.org/10.1093/NDT/GFY214
  5. El-Khashab, S. O., & Behiry, M. E. (2019). Adiponectin and ghrelin: nutritional regulatory role in chronic kidney disease patients. The Egyptian Journal of Internal Medicine 2019 31:1, 31(1), 99–105. https://doi.org/10.4103/EJIM.EJIM_78_18
  6. Gliselda, V. K. (2021). Diagnosis dan Manajemen Penyakit Ginjal Kronis (PGK). Jurnal Medika Utama, 2(4). http://jurnalmedikahutama.com
  7. Hayati, D. M., Widiany, F. L., & Nofiartika, F. (2021). Status gizi berdasarkan dialysis malnutrition score (DMS) dengan kualitas hidup pasien hemodialisis. Jurnal Gizi Klinik Indonesia, 18(1), 28–37. https://doi.org/10.22146/IJCN.60778
  8. Iorember, F. M. (2018). Malnutrition in chronic kidney disease. Frontiers in Pediatrics, 6, 379132. https://doi.org/10.3389/FPED.2018.00161/BIBTEX
  9. Kementerian Kesehatan RI. (2023). Ditjen P2p Laporan Kinerja Semester I Tahun 2023.
  10. Loho, I. K. A., Rambert, G. I., & Wowor, M. F. (2016). Gambaran kadar ureum pada pasien penyakit ginjal kronik stadium 5 non dialisis. EBiomedik, 4(2). https://doi.org/10.35790/EBM.V4I2.12658
  11. Lubis, R., Siregar, Y., & Irianti, E. (2018). Identifikasi Penyebab Penyakit Ginjal Kronik pada Usia di Bawah 45 Tahun di Unit Hemodialisis Rumah Sakit Ginjal Rasyida Medan Tahun 2015. Anatomica Medical Journal, 1(3), 159–166. https://doi.org/10.30596/ANATOMICA
  12. Meza-Valderrama, D., Marco, E., Dávalos-Yerovi, V., Muns, M. D., Tejero-Sánchez, M., Duarte, E., & Sánchez-Rodríguez, D. (2021). Sarcopenia, Malnutrition, and Cachexia: Adapting Definitions and Terminology of Nutritional Disorders in Older People with Cancer. Nutrients, 13(3), 1–11. https://doi.org/10.3390/NU13030761
  13. Moreno-González, R., Cruzado, J. M., Corsonello, A., Fabbietti, P., Tap, L., Mattace-Raso, F., Ärnlöv, J., Carlsson, A. C., Guligowska, A., Kostka, T., Artzi-Medvedik, R., Melzer, I., Roller-Wirnsberger, R., Wirnsberger, G., Kob, R., Sieber, C., Lattanzio, F., & Formiga, F. (2024). Kidney function and other associated factors of sarcopenia in community-dwelling older adults: The SCOPE study. European Journal of Internal Medicine, 123, 81–93. https://doi.org/10.1016/J.EJIM.2023.12.002
  14. Nareswari, A., Haq, N. A., & Kusumastuty, I. (2023). Diet Rendah Protein terhadap Status Kesehatan Pasien Penyakit Ginjal Kronik (PGK): Kajian Pustaka. Journal of Nutrition College, 12(4), 277–286. https://doi.org/10.14710/JNC.V12I4.38082
  15. Ozturk, G. Z., & Toprak, D. (2019). The relationship between glomerular filtration rate, nutrition and activities of daily living in patients with chronic kidney disease receiving homecare. Progress in Nutrition, 21(1), 135–140. https://doi.org/10.23751/PN.V21I1.6704
  16. Putri, S. I., Dewi, T. K., & Ludiana, L. (2023). Penerapan Slow Deep Breathing terhadap Kelelahan (Fatigue) pada Pasien Gagal Ginjal Kronik di Ruang HD RSUD Jendral Ahmad Yani Metro Tahun 2022. Jurnal Cendikia Muda, 3(2), 291–299. https://jurnal.akperdharmawacana.ac.id/index.php/JWC/article/view/471
  17. Satti, Y. C., Mistika, S. R., & Imelda, L. (2021). Faktor-Faktor yang Mempengaruhi Status Gizi Pasien Hemodialisa di Rumah Sakit Stella Maris Makassar. Jurnal Keperawatan Florence Nightingale, 4(1), 1–8. https://doi.org/10.52774/jkfn.v4i1.54
  18. Sheikh, R. Y., Samoon, H. J., Bhat, N. A., & Wani, I. (2022a). Malnutrition and inflammatory parameters in patients with chronic kidney disease stages 3–5 from northern India. The Egyptian Journal of Internal Medicine 2022 34:1, 34(1), 1–6. https://doi.org/10.1186/S43162-022-00149-1
  19. Singhal, S., Singh, S., Upadhyay, A. D., Dwivedi, S. N., Das, C. J., Mohta, S., Chatterjee, P., Dey, A. B., & Chakrawarty, A. (2019). Serum creatinine and cystatin C-based index can be a screening biomarker for sarcopenia in older population. European Geriatric Medicine, 10(4), 625–630. https://doi.org/10.1007/S41999-019-00197-X/FIGURES/1
  20. Soysal, P., Heybeli, C., Koc Okudur, S., Caliskan Bozyel, E., Smith, L., & Kazancioglu, R. (2023). Prevalence and co-incidence of geriatric syndromes according to glomerular filtration rate in older patients. International Urology and Nephrology, 55(2), 469–476. https://doi.org/10.1007/S11255-022-03356-5/TABLES/3
  21. Xi, W. Z., Wu, C., Liang, Y. L., Wang, L. L., & Cao, Y. H. (2022). Analysis of malnutrition factors for inpatients with chronic kidney disease. Frontiers in Nutrition, 9. https://doi.org/10.3389/FNUT.2022.1002498
  22. Zhou, Y., Hellberg, M., Svensson, P., Höglund, P., & Clyne, N. (2018). Sarcopenia and relationships between muscle mass, measured glomerular filtration rate and physical function in patients with chronic kidney disease stages 3-5. Nephrol Dial Transplant, 382, 342–348. https://doi.org/10.1093/ndt/gfw466

Open Access Copyright (c) 2025 Yenny Darmawaty Pangaribuan, Inggita Kusumastuty
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here