[Nutritional status of patients on chronic hemodialysis]

Abstract

The objective was to determine the nutritional status (NS) in a population undergoing chronic hemodialysis (CHD), and correlate it with dialysis dose and morbimortality. A total of 55 patients, 27 men and 28 women, aged 47 +/- 15 and with a history of CHD of 54.6 +/- 47.6 months were evaluated. NS was classified into: adequate, mild malnutrition, moderate malnutrition and severe malnutrition. A score based on usual laboratory data (total iron-binding capacity [TIBC], albumin and cholesterol), clinical evaluation and anthropometric measurements (body mass index [BMI], mid brachial circumference, tricipital fold [TF], mid brachial muscle circumference [MBMC]), was used. In addition, a 7-days' intake auto-registration plan was conducted, and protein catabolic rate (PCR) was determined. Calorie intake was of 27 +/- 13 kcal/kg/day and protein intake was of 1.2 +/- 0.5 g/kg/day. No correlation was found between the latter and PCR. 49.1% of patients had moderate to severe malnutrition, only 9 patients had an adequate NS. However anthropometric measurements showed that TF, MBMC and BMI were normal in 54.5%, 45%, and 72.7% of patients, respectively. No correlation was found between NS and age onset of CHD, sex, creatinine, dialysis dose (Kt/V x = 1.24 +/- 0.12), PCR and morbidity. A longer history of dialysis was associated with a worse NS (p < 0.01). In addition, NS significantly correlated with albumin (p < 0.01) and mortality (p < 0.05). The estimated death risk was 9.45 times higher in patients with moderate and severe malnutrition.