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논문분류	춘계학술대회 초록집
제목	Protein-Energy Wasting, Risk Factors for Death and Composite Outcomes in CKD Patients Not Receiving Kidney Replacement Therapy
저자	Hojung Lee
출판정보	2025; 2025(1):
키워드	Protein-energy wasting, non-dialysis-dependent chronic kidney disease, all-cause mortality, composite outcomes
초록	Protein–energy wasting (PEW) is a strong indicator of adverse outcomes such as all-cause mortality and cardiovascular events. Although this association has been reported primarily in patients with dialysis, it has not been clearly demonstrated in patients with non-dialysis–dependent chronic kidney disease (NDD-CKD). The current study aimed to evaluate the association of PEW with all-cause death or composite of any cardiovascular event and all-cause death in patients with NDD-CKD. We evaluated the association of PEW with adverse outcomes in patients with NDD-CKD through a prospective cohort study. We analyzed clinical data from 1,847 patients with CKD (median follow-up duration was 6.94 years). The definition of PEW followed the International Society of Renal Nutrition and Metabolism criteria: serum albumin < 3.8 g/dL, body mass index < 23.0 kg/m2, skeletal muscle mass < 19.7 kg in women, < 26.9 kg in men, and low dietary protein intake < 0.6 g/kg/day. During 6.94 years, 129 deaths and 264 composite outcomes (all cause death or cardiovascular events) occurred. In the Cox proportional hazards regression analysis, all-cause death and composite outcomes were significantly increased in the subgroups with two or more PEW parameters. All-cause death increased in patients with two PEW parameters (hazard ratio [HR], 2.777; 95% confidence interval [CI], 1.605-4.084; P < 0.001) and those with three or more PEW parameters (HR, 3.782; 95% CI, 1.814–7.888; P < 0.001). Composite outcomes also showed a significant increase in patients with two (HR, 2.164; 95% CI, 1.508–3.105; P < 0.001) and three or more PEW parameters (HR, 2.296; 95% CI, 1.296–4.068; P = 0.004). Significant increases of all cause death and composite outcomes were found among patients with two or more PEW parameters. PEW was a strong indicator of all-cause death and composite outcomes among NDD-CKD patients.
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