<p> Association of Protein Energy Wasting with income In CKD Stage 3 Patients.</p><p>Anita Saxena, Amit Gupta </p><p>NEPHROLOGY, SANJAY GANDHI POST GRADUATE INSTITUTE OF MEDICAL SCEINCES, LUCKNOW, UP, India.</p><p>Key words: Protein energy wasting, appetite, income, BMI</p><p>Abstract Protein energy wasting (PEW) is a major challenge in CKD. Objective: To assess PEW in predialysis patients at first visit to a nephrologist. Methods: Three day dietary intake of 484 CKD stage 3 patients was taken. Appetite was assessed with ADAT Patients were divided in to groups based on appetite and BMI. </p><p>Results: Male and female parameters are serum albumin 3.7±0.84/ 3.68.8±.81g/dL, total protein 7.02±1.27/6.94 ±1.26 g/dL, creatinine 4.68± 4.19 / 3.74±3.36 mg% creatinine clearance 33.22± 30.48/ 37.55±33.87 ml/minute, BMI 22.60±4.29/23.43±4.77kg/m2 energy/kg16.97±0.65/16.8±0.64, protein g/kg 0.65 ±0.28/0.64±0.30, carbohydrate g/kg 2.98 ±1.54/2.98±.1.36, fat g/kg 2.98±0.23/2.79±0.22, respectively. As appetite decreased dietary protein and energy intake decreased significantly (Table 1). Appetite in males and females: Average 14.46%, 4.13% poor 9.7%, 18.18%, anorexic 13.2%, 7.4%. Table 1 Appetite, Protein and Energy Intake Varible/Sex Normal Average Poor Anorexic N 1/126 N 70/20 N 88/47 N 64/36 Protein 0.79±.23 0.58 ± .17 0.50 ± .20 0.27 ±.17 g/kg /Male Protein g/kg 0.79±..23 0.56 ±.16 0.48 ±.15 0.29 ±.20 /Female Energy 21.57 ± 25± 3.70 12.36±4.26 6.92 ±4.36 cal/kg /Male 7.85 Energy 21.19±5.81 14.67±3.09 12.79±3.92 7.25±3.95 cal/kg /Female</p><p>Income had strong correlation with BMI (p.000), dietary protein (p.000) energy (p.000) and carbohydrate (p.000). Appetite correlated with creatinine (p 0.019), dietary energy, protein, carbohydra0te and fat (p.000) intake. BMI correlated (p0.000) with fat, carbohydrate, energy and creatinine clearance. Anova showed significant difference within and between appetite groups in energy, protein, fat, carbohydrate, creatinine clearance (p0.000) and serum albumin (p 0.025). There was significant difference in protein (p0.026) energy intake (p 0.000) and creatinine clearance (p0.038) within and between BMI groups. Based on income there was significant difference between groups in BMI (0.000), energy (p0.019), protein (p 0.031), albumin (0.001). </p><p>**************************************************************************************************</p><p>Bioelectrical Impedance Analysis As A Screening Tool For Chronic Kidney Disease. Dr Anita Saxena, Amit Gupta, SGPGIMS, Lucknow</p><p>Chronic Kidney Disease (CKD) has a latent period during which the disease is present but asymptomatic. With increasing incidence of hypertension and diabetes, incidence and prevalenceof CKD is on increase. Bioelectric impedance analysis (BIA) a noninvasive method for estimation of body composition in clinical</p><p> setting but it has not been used for CKD screening. Objectives: To evaluate applicability of BIA as a screening tool for presence of kidney disease in general population by estimating body water compartments, creatinine clearance and glomerular filtration rate (GFR). Material and methods: A pilot-cross-sectional CKD screening study on randomly selected 52 subjects from general population. Maltron BIOSCAN analyzer 915/916 was validated with Hume etal's equation for estimation of total body water. BIA derived GFR was validated with DTPA</p><p> nuclear scan derived GFR, a study done on voluntary healthy kidney donors.</p><p>Results: There was no significant difference between total body water estimated with BIA and Hume etal's equation and BIA derived GFR and DTPA nuclear scan GFR. Mean serum creatinine for males was 0.94 ± 0.14mg% and 0.91± 0.84mg % for females. BIA derived creatinine clearance was 97.39± 28.98 in males and107.60± 34.03 in females, GFR was 74.1±25.98 ml/min/1.73 m2in males and 65.17 ±21.14 ml/min1.73 m2 in females. Based on GFR subjects were classified into CKD. Out of 52 subjects 8 were in CKD stage 1 (15.5%), 23 (44.2%) were in CKD stage 2, 18 (34.6%) were in CKD stage 3 , 1 (1.9%/1.9%) each in CKD stage 4 and CKD stage 5 respectively. Incidentally, 13.5% were diabetic. and 65.8% were hypertensive. Mean blood pressure was 133.99 ±40.89/82.76 ±27.79 mmHG in males and 132.10 ±16.20/ 83.46± 7.85mmHG in females. Based on American Heart Association classification for hypertension, 19 (36%) patients had normal blood pressure, 8 (15.5%) were in prehypertensive stage, 16 (30.7%) patients were in hypertension stage 1, 6 (11.5%) were in hypertension stage 2 and 2 had crisis hypertension.</p><p>• Conclusion: Population-based CKD screening programs can identify people with renal injury for early intervention. BIA can be used for screening CKD in general population. It can also be a routine test as 99mTec-DTPA scan for estimation of GFR. </p>