Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States

Abstract Background Previous studies focused on the relationship between nutritional status and adverse outcomes in patients with chronic kidney disease (CKD). However, the relationship between malnutrition and CKD in community-dwelling older adults in the United States is largely unknown. Methods O...

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Main Authors: Rongting Zhang, Ke Zhu, Kaijun Zhang, Yinxia Zhu, Yani Wang, Ying Liao, Yong Fang, Yunli Shen
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06243-7
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author Rongting Zhang
Ke Zhu
Kaijun Zhang
Yinxia Zhu
Yani Wang
Ying Liao
Yong Fang
Yunli Shen
author_facet Rongting Zhang
Ke Zhu
Kaijun Zhang
Yinxia Zhu
Yani Wang
Ying Liao
Yong Fang
Yunli Shen
author_sort Rongting Zhang
collection DOAJ
description Abstract Background Previous studies focused on the relationship between nutritional status and adverse outcomes in patients with chronic kidney disease (CKD). However, the relationship between malnutrition and CKD in community-dwelling older adults in the United States is largely unknown. Methods Overall, 8,219 participants were included in this study, and classified as normal nutritional status, mild malnutrition, and moderate to severe malnutrition by Controlling Nutritional Status (CONUT) score. The relationship between malnutrition and the risk of CKD was investigated through a multivariable logistic regression analysis. Results The average age of participants in this study was 73.0 ± 5.5 years, 3,517 (40%) had CKD. A multivariate logistic regression model revealed that, compared to a normal nutritional state, malnutrition was significantly associated with an increased risk for CKD. The adjusted odds ratios (OR) for mild and moderate to severe malnutrition were 1.27 (95% confidence interval [CI]: 1.04–1.54) and 1.88 (95% CI: 1.19–2.97), respectively. However, among male participants, malnutrition did not show a relationship with the prevalence of CKD, with adjusted ORs of 1.00 (95% CI: 0.78–1.30) for mild malnutrition and 1.47 (95% CI: 0.87–2.49) for moderate to severe malnutrition. Our findings showed that there was an interaction between sex and malnutrition in relation to CKD risk (P for interaction < 0.001). Conclusions In elderly participants, malnutrition is significantly correlated with a higher prevalence of CKD, and sex can modify the relationship between them.
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spelling doaj-art-37352a7124584d35ae2aa2e1dfb10d9b2025-08-20T04:02:56ZengBMCBMC Geriatrics1471-23182025-07-0125111010.1186/s12877-025-06243-7Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United StatesRongting Zhang0Ke Zhu1Kaijun Zhang2Yinxia Zhu3Yani Wang4Ying Liao5Yong Fang6Yunli Shen7Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji UniversityDepartment of Cardiology, Shanghai East Hospital, School of Medicine, Tongji UniversityDepartment of Pulmonary and Critical Care Medicine, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Cardiology, Shanghai East Hospital, School of Medicine, Tongji UniversityDepartment of Cardiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Cardiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Cardiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Cardiology, Shanghai East Hospital, School of Medicine, Tongji UniversityAbstract Background Previous studies focused on the relationship between nutritional status and adverse outcomes in patients with chronic kidney disease (CKD). However, the relationship between malnutrition and CKD in community-dwelling older adults in the United States is largely unknown. Methods Overall, 8,219 participants were included in this study, and classified as normal nutritional status, mild malnutrition, and moderate to severe malnutrition by Controlling Nutritional Status (CONUT) score. The relationship between malnutrition and the risk of CKD was investigated through a multivariable logistic regression analysis. Results The average age of participants in this study was 73.0 ± 5.5 years, 3,517 (40%) had CKD. A multivariate logistic regression model revealed that, compared to a normal nutritional state, malnutrition was significantly associated with an increased risk for CKD. The adjusted odds ratios (OR) for mild and moderate to severe malnutrition were 1.27 (95% confidence interval [CI]: 1.04–1.54) and 1.88 (95% CI: 1.19–2.97), respectively. However, among male participants, malnutrition did not show a relationship with the prevalence of CKD, with adjusted ORs of 1.00 (95% CI: 0.78–1.30) for mild malnutrition and 1.47 (95% CI: 0.87–2.49) for moderate to severe malnutrition. Our findings showed that there was an interaction between sex and malnutrition in relation to CKD risk (P for interaction < 0.001). Conclusions In elderly participants, malnutrition is significantly correlated with a higher prevalence of CKD, and sex can modify the relationship between them.https://doi.org/10.1186/s12877-025-06243-7MalnutritionChronic kidney diseaseElderlyControlling nutritional status scoreSex differences
spellingShingle Rongting Zhang
Ke Zhu
Kaijun Zhang
Yinxia Zhu
Yani Wang
Ying Liao
Yong Fang
Yunli Shen
Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
BMC Geriatrics
Malnutrition
Chronic kidney disease
Elderly
Controlling nutritional status score
Sex differences
title Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
title_full Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
title_fullStr Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
title_full_unstemmed Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
title_short Sex modifies the association between malnutrition and chronic kidney disease in community-dwelling older adults in the United States
title_sort sex modifies the association between malnutrition and chronic kidney disease in community dwelling older adults in the united states
topic Malnutrition
Chronic kidney disease
Elderly
Controlling nutritional status score
Sex differences
url https://doi.org/10.1186/s12877-025-06243-7
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