Nutritional assessment and dietary intake patterns in early-stage chronic kidney disease: a hospital-based cross-sectional study

Chronic Kidney Disease (CKD) presents a rapidly growing public health challenge in India, with early stages offering a critical window for nutritional intervention. This hospital-based cross-sectional study assesses nutritional intake, anthropometric measurements, biochemical markers, and appetite status among adults with CKD stages 1–3 (n = 184) attending outpatient nephrology departments of two tertiary care hospitals in Hyderabad, India. Assessment tools include a Food Frequency Questionnaire (FFQ), 24-h dietary recall, Subjective Global Assessment (SGA), and the Council on Nutrition Appetite Questionnaire (CNAQ). Mean age is 47.6 ± 12.1 years; 59.8% are male. Stage distribution is: Stage 1 (10.9%), Stage 2 (25.5%), Stage 3a (34.2%), and Stage 3b (29.3%). Mean protein intake is 0.82 ± 0.21 g/kg/day; based on single 24-hour dietary recall estimates, a substantial proportion appeared to exceed recommended sodium (approximately 64%) and potassium (approximately 58%) thresholds, representing directional trends rather than precise habitual intake values; 34.2% are malnourished by SGA.Estimated glomerular filtration rate (eGFR) category correlates negatively with haemoglobin (r = − 0.350, p < 0.001) and positively with urinary albumin-to-creatinine ratio (UACR; r = + 0.350, p < 0.001), and negatively with CNAQ score (r = − 0.244, p = 0.001), indicating that lower appetite co-varies with more advanced CKD stages. In a multivariable linear regression modelling eGFR as a continuous outcome, older age (β = −0.65, p < 0.001), male sex (β = +7.48, p = 0.014), and higher BMI (β = +0.70, p = 0.044) were independently associated with eGFR (adjusted R² = 0.16); haemoglobin and CNAQ score were independently not associated with eGFR after adjustment. Older age, male sex, and higher BMI were independently associated with eGFR in this cross-sectional cohort, while dietary patterns, appetite (CNAQ), and haemoglobin showed significant bivariate associations with CKD stage that were not retained in the adjusted model. Systematic nutritional assessment and individualised dietary counselling nonetheless remain clinically relevant given the high observed burden of suboptimal dietary patterns and reduced appetite in this population.