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Original Article

Dietary intake patterns and nutritional adequacy in older adults with predialysis chronic kidney disease: a comparison by diabetes status

Clinical Nutrition Research 2026;15(2):108-116.
Published online: April 30, 2026

1Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea

2Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea

3Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea

4Department of Nutrition, Yongin Severance Hospital, Yongin, Korea

Correspondence to: Yoo Kyoung Park Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin 17104, Korea Email: ypark@khu.ac.kr
• Received: April 7, 2026   • Revised: April 22, 2026   • Accepted: April 27, 2026

© 2026 The Korean Society of Clinical Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Lessons from marine osmoregulation: Comparative perspectives on salt-sensitive hypertension and human kidney–cardiovascular protection
    Wiharjo Hadisuwarno, Dante Saksono Harbuwono, Edwin Hadinata, Pringgodigdo Nugroho, Eka Ginanjar, Dananti Kusumawindani, Raymond Rubianto Tajndrawinata, Sovia Salamah, Fahrul Nurkolis
    Current Research in Biotechnology.2026; 12: 100412.     CrossRef

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Dietary intake patterns and nutritional adequacy in older adults with predialysis chronic kidney disease: a comparison by diabetes status
Clin Nutr Res. 2026;15(2):108-116.   Published online April 30, 2026
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Clin Nutr Res. 2026;15(2):108-116.   Published online April 30, 2026
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Dietary intake patterns and nutritional adequacy in older adults with predialysis chronic kidney disease: a comparison by diabetes status
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Fig. 1. Major food-group intake of participants compared with recommendation. DM, diabetes mellitus.
Dietary intake patterns and nutritional adequacy in older adults with predialysis chronic kidney disease: a comparison by diabetes status
Characteristic DM comorbidity
Total (n=106) DM (n=67) Non-DM (n=39) P-value
Age (yr) 76.6±6.2 76.4±6.4 76.9±5.8 0.671
Male sex 60 (56.6) 42 (62.7) 18 (46.2) 0.098
Periods of medical treatment (mo) 31.2±35.2 32.2±36.5 29.5±33.1 0.704
CKD stage
 Stage 3a 22 (20.8) 15 (22.4) 7 (17.9) 0.304
 Stage 3b 52 (49.1) 29 (43.3) 23 (59.0)
 Stage 4 29 (27.4) 20 (29.9) 9 (23.1)
 Stage 5 3 (2.8) 3 (4.5) 0 (0.0)
Comorbidity
 Hypertension 96 (90.6) 64 (95.5) 32 (82.1) 0.022*
 Anemia 19 (17.9) 11 (16.4) 8 (20.5) 0.596
 Dyslipidemia 12 (11.3) 4 (6.0) 8 (20.5) 0.023*
 Proteinuria 63 (59.4) 42 (62.7) 21 (53.8) 0.371
 Hyperkalemia 19 (17.9) 12 (17.9) 7 (17.9) 0.996
Education
 Uneducated 8 (7.5) 3 (4.5) 5 (12.8) 0.245
 Elementary school 28 (26.4) 15 (22.4) 13 (33.3)
 Middle school 14 (13.2) 11 (16.4) 3 (7.7)
 High school 39 (36.8) 27 (40.3) 12 (30.8)
 College or higher 17 (16.0) 11 (16.4) 6 (15.4)
Smoking status
 Never 85 (80.2) 53 (79.1) 32 (82.1) 0.888
 Current 7 (6.6) 5 (7.5) 2 (5.1)
 Former 14 (13.2) 9 (13.4) 5 (12.8)
Current drinking status
 Yes 16 (15.1) 12 (17.9) 4 (10.3) 0.288
 No 90 (84.9) 55 (82.1) 35 (89.7)
Diet management
 Yes 26 (24.5) 12 (17.9) 14 (35.9) 0.038*
 No 80 (75.5) 55 (82.1) 25 (64.1)
Subjective Global Assessment
 Mildly to moderately malnourished 12 (11.3) 9 (13.4) 3 (7.7) 0.368
 Well nourished 94 (88.7) 58 (86.6) 36 (92.3)
Parameter DM comorbidity
Total (n=106) DM (n=67) Non-DM (n=39) P-value
Anthropometric parameter
 Height (cm) 157.7±12.0 158.9±8.9 157.9±7.2 0.548
 Weight (kg) 65.0±14.1 65.4±10.4 61.9±9.9 0.087
 BMI (kg/m2) 25.5±3.4 25.9±3.3 24.8±3.4 0.109
 SBP (mmHg) 134.1±18.3 135.6±18.3 131.5±18.3 0.262
 DBP (mmHg) 65.0±12.3 64.6±12.3 65.7±12.5 0.655
 TSF (mm) 16.0±6.0 15.7±5.7 16.6±6.5 0.432
 MAMC (cm) 22.1±3.0 22.3±3.1 21.8±2.8 0.385
Biochemical parameter
 Glucose (mg/dL) 111.7±27.8 114.8±31.3 106.5±20.0 0.098
 Hemoglobin (g/dL) 11.8±1.8 11.9±2.0 11.8±1.6 0.913
 Total protein (g/dL) 6.9±0.5 6.9±0.5 6.8±0.5 0.632
 Albumin (g/dL) 4.3±0.3 4.3±0.3 4.3±0.3 0.505
 eGFR (mL/min/1.73 m2) 35.4±11.1 35.0±12.2 36.2±9.0 0.596
 BUN (mg/dL) 31.2±11.7 32.8±13.4 28.5±7.3 0.035*
 Creatinine (mg/dL) 1.8±0.7 1.9±0.8 1.6±0.4 0.035*
 Cystatin C (mg/L) 2.0±0.6 2.1±0.7 1.9±0.4 0.099
 PCR (mg/g) 579.3±796.5 689.7±873.8 394.3±614.1 0.052
 Uric acid (mg/dL) 6.6±1.6 6.8±1.7 6.3±1.5 0.131
 Calcium (mg/dL) 9.2±0.4 9.2±0.4 9.2±0.4 0.982
 Phosphorus (mg/dL) 3.7±0.6 3.8±0.6 3.5±0.6 0.036*
 Sodium (mmol/L) 140.7±2.2 140.6±2.5 140.8±1.7 0.553
 Potassium (mmol/L) 5.0±0.7 5.0±0.7 4.9±0.6 0.232
 Chloride (mmol/L) 106.5±3.0 106.5±3.3 106.5±2.3 0.983
 Cholesterol (mg/dL) 138.6±29.9 134.2±29.5 146.0±29.4 0.050
Nutrient intake DM comorbidity
Total (n=106) DM (n=67) Non-DM (n=39) P-value
Energy (kcal) 1,388.7±435.0 1,429.1±472.4 1,319.2±357.0 0.211
Energy (kcal/kg) 24.5±7.0 24.9±7.4 23.9±6.3 0.462
Macronutrient
 Carbohydrate (g) 208.2±65.4 209.8±69.3 205.5±58.8 0.742
 Protein (g/kg) 0.9±0.4 1.0±0.4 0.8±0.2 0.049*
 Protein (g) 52.3±21.0 55.6±23.5 46.7±14.2 0.017*
  Animal (% total protein) 40.4±20.5 40.5±21.5 40.3±18.9 0.958
  Plant (% total protein) 59.6±20.5 59.5±21.5 59.7±18.9 0.958
 Fat (g) 32.3±18.1 33.0±20.6 31.1±13.0 0.564
  Animal (% total fat) 45.6±26.6 44.1±26.2 48.1±27.4 0.460
  Plant (% total fat) 54.4±26.6 55.9±26.2 51.9±27.4 0.460
 Saturated fat (g) 10.9±14.7 9.8±10.1 12.8±20.4 0.304
 Cholesterol (mg) 209.2±191.4 235.8±209.1 163.5±147.9 0.060
 Fiber (g) 21.4±13.1 22.2±14.6 20.1±10.0 0.434
 Carbohydrate:protein:fat (%) 63:16:21 63:16:21 64:15:21
Mineral and vitamin
 Sodium (mg) 2,659.7±1,407.5 2,707.1±1,529.8 2,578.3±1,182.8 0.652
 Potassium (mg) 2,052.3±993.5 2,193.9±1,090.4 1,809.1±752.5 0.054
 Phosphorus (mg) 804.0±318.1 843.6±339.0 736.1±269.3 0.093
 Calcium (mg) 420.4±235.5 433.8±232.4 397.6±242.1 0.448
 Iron (mg) 17.6±23.0 18.8±25.0 15.6±19.0 0.498
 Vitamin A (µg RAE) 254.1±222.0 274.4±243.7 219.3±176.4 0.219
 Vitamin E (mg) 11.6±8.0 12.2±8.3 10.6±7.4 0.326
 Folate (µg) 372.8±204.7 408.6±233.0 311.2±123.8 0.006*
 Vitamin C (mg) 62.3±65.5 71.3±74.9 47.0±41.6 0.065
 Thiamin (mg) 1.3±0.6 1.3±0.7 1.2±0.5 0.172
 Riboflavin (mg) 1.0±0.6 1.1±0.6 0.9±0.6 0.259
 Niacin (mg) 8.6±4.3 9.2±4.8 7.6±3.1 0.038*
Variable DM comorbidity
Total (n=106) DM (n=67) Non-DM (n=39) P-value
Below On Above Below On Above Below On Above
Energy 90 (84.9) 6 (5.7) 10 (9.4) 56 (83.6) 3 (4.5) 8 (11.9) 34 (87.2) 3 (7.7) 2 (5.1) 0.427
Protein 16 (15.1) 32 (30.2) 58 (54.7) 10 (14.9) 18 (26.9) 39 (58.2) 6 (15.4) 14 (35.9) 19 (48.7) 0.584
Phosphorus 58 (54.7) 23 (21.7) 25 (23.6) 34 (50.7) 14 (20.9) 19 (28.4) 24 (61.5) 9 (23.1) 6 (15.4) 0.311
Sodium 30 (28.3) 15 (14.2) 61 (57.5) 18 (26.9) 11 (16.4) 38 (56.7) 12 (30.8) 4 (10.3) 23 (59.0) 0.665
Table 1. General characteristics of participants according to DM comorbidity

Values are presented as mean±standard deviation or number (%) and compared using the chi-square test or independent t-test.

DM, diabetes mellitus; CKD, chronic kidney disease.

P<0.05 for chi-square test.

Table 2. Anthropometric and biochemical measurements of participants according to DM comorbidity

Values are presented as mean±standard deviation and compared using the independent t-test.

DM, diabetes mellitus; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TSF, triceps skinfold thickness; MAMC, mid-upper arm muscle circumference; eGFR, estimated glomerular filtration rate; BUN, blood urea nitrogen; PCR, protein creatinine ratio.

P<0.05 was considered statistically significant.

Table 3. Nutrient intake of participants according to DM comorbidity

Values are presented as mean±standard deviation and compared using the independent t-test.

DM, diabetes mellitus; RAE, retinol activity equivalents.

P<0.05 was considered statistically significant.

Table 4. Energy and nutrient intake of patients with predialysis chronic kidney disease (stages 3–5) compared with the recommended levela)

Values are presented as number (%) and compared using the chi-square test.

DM, diabetes mellitus.

2013 International Society of Renal Nutrition and Metabolism guideline.