Protein-Energy Wasting and Associated Factors Among Chronic Kidney Disease Patients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Figures & data

Table 1 Socio-Economic and Demographic Characteristics of CKD Patients Attending Adult OPD at St Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	Frequency	Percent
Sex  Male  Female	164 110	59.9 40.1
Age  18–34  35–49  50–64  ≥65	75 101 60 38	27.4 36.9 21.9 13.9
Marital Status  Single  Married  Divorced  Widowed	54 160 36 24	19.7 58.4 13.1 8.8
Religion  Orthodox  Muslim  Protestant  Catholic	149 54 54 17	54.4 19.7 19.7 6.2
Educational level  Illiterate  Elementary  Secondary  Diploma, Degree and above	60 74 50 90	21.9 27.0 18.2 32.8
Occupational status  Government employee  Merchants  House wife  Daily laborer  Farmer  NGO/private and Retired	82 39 37 28 33 55	29.9 14.2 13.5 10.2 12.0 20.1
Ethnicity  Oromo  Amhara  Gurage  Tigre and Kafa	96 81 53 44	35.0 29.6 19.3 16.0
Family Monthly Income  < 1500  1501–3500  3501–5000  > 5001	80 69 52 73	29.2 25.2 19.0 26.6
Family Size of household  ≤5  > 5	144 130	52.6 47.4

Table 2 Disease and Health-Related Characteristics of CKD Patients Attending Renal Unit at St Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	Frequency	Percent
Hemoglobin value (g/dl) For Male  ≤13  >13 For Female  ≤12  >12	56 109 33 76	20.4 39.8 12 27.7
Family history of chronic disease  Diabetes mellitus  Hypertension  Chronic kidney disease  Other(CVD)	104 34 44 18 8	38 32.7 42.3 17.3 7.7
History of chronic disease before CKD  Hypertension  Diabetes mellitus  Acute kidney infection  Heart disease  Others(CVD, Anemia)	166 69 42 31 5 19	61 41.6 25.3 18.7 3 11.4
Types of chronic disease currently present  Only Chronic kidney disease  Diabetes mellitus  Hypertension  Diabetes mellitus and Hypertension  Others(CVD, combination of others)	39 36 116 49 34	14.2 13.1 42.3 17.9 12.4
Duration of CKD  < 1  ≥1	58 216	21.2 78.8
History of tobacco smoking  No  Yes	241 32	88.3 11.7
Ever consumed alcohol like beer, wine, or local beverages like teji, tella, areke, etc  No  Yes	189 85	69 31

Table 3 Dietary Practice and Physical Activity Characteristics of CKD Patients Attending Adult OPD at St Paulo’s Hospital Millennium Medical College, AA, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	Frequency	Percent
Eat foods regularly from restaurants  Yes  No	77 197	28.1 71.9
Type of oil often used for meal preparation  Liquid oil  Solid oil  Solid oil and Butter	73 146 55	26.6 53.3 20.1
Meat and meat product meals eat per week  2–3 days per w/k  1 per 2wk  1 per month  Only holiday	32 81 74 87	11.7 29.6 27.0 31.8
Advised to reduce salt intake  Yes  No	257 17	93.8 6.2
Adhere to reduce salt intake  No  Yes	38 219	14.8 85.2
Eat fruit and vegetables  No  Yes	40 234	14.6 85.4
How often eat vegetables and fruits  Most of the time  Rarely	76 158	32.5 67.5
Have dietary plan set with doctor  No  Yes	149 125	54.4 45.6
Adhere to your dietary plan  No  Yes	15 110	12.0 88.0
History of anorexia or loss of appetite  No  Yes	186 88	67.9 32.1
Moderate to vigorous intensity scheduled exercise before become sick  No  Yes	235 39	85.8 14.2
Presence of exercise plan set with doctor  No  Yes	215 59	78.5 21.5
Of those adhere to exercise plan  No  Yes	1 57	1.7 98.3
Currently activity level of the respondents  Sedentary or no exercise  Low activity  Active	19 116 139	6.9 42.3 50.7

Table 4 Anthropometric and Biochemical Marker Characteristics of CKD Patients Attending Adult OPD at St Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	Frequency	Percent
Protein-Energy Wasting  Yes  No	64 210	23.4 76.6
Serum Creatinine  Normal (0.6–1.4 mg/dl)  Elevated (> 1.4 mg/dl)	48 225	17.9 82.1
Serum Albumin  < 3.8 gm/dl  ≥= 3.8gm/dl	105 168	38.7 61.3
Blood Urea Nitrogen  Normal (10–50 mg/dl)  Elevated (> 50 mg/dl)	102 172	37.2 62.8
CKD Stage  Stage 1  Stage 2  Stage 3  Stage 4  Stage 5	15 42 85 67 65	5.5 15.3 31.0 24.5 23.7
Subjective global assessment score (median (IQR) Weight change over 3 months	13 (9,19)
No weight change  < 5% of body weight  ≥ 5% of body weight	81 90 103	29.6 32.8 37.6
Body Mass Index  < 18.5  18.5–29.5  > 29.5	72 195 7	26.3 71.2 2.6
Blood pressure  < 90/60  90/60 - 130/90  > 130/90	1 118 155	0.4 43.1 56.6

Figure 1 Prevalence of PEW according to the CKD stage of chronic kidney disease patients attending adult OPD at St Paulo’s Hospital Millennium Medical College, AA, Ethiopia, March1 to 30 April, 2019 (n=274).

Table 5 Correlation Between SGA and Some Biochemical Variables Among CKD Patients Attending Adult OPD at St Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	SGA	BUN	Serum Albumin	Serum Creatine
SGA	1
BUN	0.36	1
Serum Albumin	−0.44	−0.207	1
Serum creatinine	0.33	0.569	−0.209	1

Table 6 Multivariable Logistic Regression Analysis of Factors Associated with PEW Among CKD Patients Attending Adult OPD at St Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, March 1 to 30 April, 2019 (n=274)

Variables	Protein-Energy Wasting		COR (95% CI)	AOR (95% CI)	P-value for AOR
	Yes N (%)	No N (%)
Age  18–34  35–49  50–64  >65	11(14.7) 23(22.8) 14(23.3) 16(42.1)	64(85.3) 78((77.2) 46(76.7) 22(57.9)	1** 1.7(0.78, 3.78) * 1.8(0.74, 4.25) * 4.2(1.7, 10.49) **	2.96(1.2, 7.3) 2.0(0.77, 5. 5) 7.0 (2.4, 20.5)	0.004 0.019 0. 15 <0.001
Educational status  Illiterate  Elementary  Secondary  Diploma and above	16(26.7) 18(24.3) 14(28.0) 16(17.8)	44(73.3) 56(75.7) 36(72.0) 74(82.2)	1 0.9(0.4, 1.9) 1.1(0.46, 2.5) 0.6(0.3, 1.3)
Presence of any chronic disease before dev’t of CKD  No  Yes	19(17.6) 45(27.1)	89(82.4) 121(72.9)	1 1.74(0.95, 3.2) *	1 1.81(0.9, 3.6)	0.097
Currently presence of co-morbidity  No  Yes	6(15.4) 58(24.7)	33(84.6) 177 (75.3)	1 1.8 (0.72, 4.52) *
Family Monthly Income  <1500  1501–3500  3501–5000  >5001	23(28.8) 15(21.7) 15(28.8) 11(15.1)	57(71.2) 54(78.3) 37(71.2) 62(84.9)	1* 0.7(0.33, 1.5) 1(0.47, 2.2) 0.44(0.2,0.98) **
Duration of CKD follow up  < 1  1–5  > 5	8(13.8) 35(24.0) 21(30.0)	50(86.2) 111(76) 49(70.0)	1* 2(0.85, 4.6) * 2.7(1.1, 6.6) **
Presence of exercise plan set with doctor  No  Yes	60 (27.9) 4 (6.8)	155 (72.1) 55 (93.2)	1 0.2 (0.07, 0.54) **	1 0.18(0.057, 0.55)	0.003
History of anorexia  No  Yes	25 (13.4) 39 (44.3)	161 (86.6) 49 (55.7)	1 5(2.8, 9.3) ***	1 5.2 (2.7, 10.3)	<0.001
CKD stage  Stage 1–2  Stage 3  Stage 4–5	5 (8.8) 16(18.8) 43 (32.6)	52 (91.2%) 69(81.2) 89 (67.4)	1** 2.4 (0.83, 7.0) * 5.0 (1.9, 13.5) ***	1 2.2(0.7, 6.9) 3.6 (1.3, 10.3)	0.18 0.017

Notes: *=p<0.25, **=p≤0.05, ***=p≤0.001 and 1=reference group. Hosmer and Lemeshow’s goodness-of-fit test has chi-square of 6.4 with p value of 0.6, omnibus test of p-value of <0.001.