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The prevalence and clinical significance of loss of appetite in older patients with chronic kidney disease

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Abstract

Purpose

To determine predictors of loss of appetite among older adults with chronic kidney disease (CKD).

Methods

Demographic and clinical data, and scores of comprehensive geriatric assessment parameters of patients who were ≥ 60 years old and have CKD according to an estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m2 were reviewed. Loss of appetite was defined as a score of ≤ 28 in The Council on Nutrition Appetite Questionnaire. Logistic regression analysis was performed to determine the predictors of loss of appetite.

Results

Of the 398 patients included, 288 (72%) were female, and the mean age was 80 ± 7. Loss of appetite was present in 233 (59%) of patients. The frequency appeared to significantly increase with a decline in eGFR to < 45 mL/min/1.73 m2 (p < 0.05). Older age, female sex, the presence of frailty, and higher scores of Insomnia Severity Index and geriatric depression scale-15 were associated with a higher risk of loss of appetite, while longer time on education, higher levels of hemoglobin, eGFR, and serum potassium, and higher scores of handgrip strength, Tinetti gait and balance test, basic and instrumental activities of daily living, and Mini-Nutritional risk Assessment (MNA) were associated with a lower risk (p < 0.05). Associations between insomnia severity and geriatric depression remained significant after adjustment for all parameters including the MNA score.

Conclusion

Loss of appetite is quite common in older adults with CKD and may be a sign of poor health status in older people with CKD. There is a close relationship between loss of appetite and insomnia or depressive mood.

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Fig. 1

Data availability

Data were available for analysis at the Department of Geriatric Medicine in Bezmialem Vakif University, Istanbul. Turkiye. If needed, the corresponding author can share the data.

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Authors and Affiliations

Authors

Contributions

Conceptualization: PS, CH, and SY; data curation: PS, LS, and SY; formal analysis: CH; methodology: CH, PS, LS, and SY; writing: SY and CH; validation: all authors; review and editing: PS, LS, and RK; supervision: PS and RK.

Corresponding author

Correspondence to Pinar Soysal.

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The authors declare no conflicts of interest.

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This study was approved by the local Ethics Committee.

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Informed consent was taken from all patients.

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Yildiz, S., Heybeli, C., Smith, L. et al. The prevalence and clinical significance of loss of appetite in older patients with chronic kidney disease. Int Urol Nephrol 55, 2295–2302 (2023). https://doi.org/10.1007/s11255-023-03540-1

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  • DOI: https://doi.org/10.1007/s11255-023-03540-1

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