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The most traditionally used prediction equations overestimated the REE of CKD patients, and the errors were minimized in the presence of comorbidities. There is a need to develop population-specific equations in order to adequately estimate the energy requirement of these patients.

Body-fat gain is a common finding among peritoneal dialysis (PD) patients, and the accumulation of adipose tissue occurs predominantly in the abdominal area. Waist circumference (WC) is a reliable marker of abdominal obesity and its association with worse outcomes has been demonstrated in non-dialysis and haemodialysis patients. We aimed at investigating whether WC measurements as well as the changes over time in WC were able to predict mortality in PD patients. This prospective study included 109 patients undergoing PD (57 % male, age 52 (sd 16) years, 32 % diabetics, 48 % BMI≥25 kg/m2). WC was measured at the umbilicus level (empty abdominal cavity), and values >88 cm for women and >102 cm for men were considered high. Nutritional status and laboratory parameters were also evaluated. WC was measured at baseline and after 6 months, and mortality was registered during a period of 48 months. High WC was observed in 55 % of women and in 23 % of men at baseline. After 6 months, 61 % of the patients showed an increased WC. At the end of the study, twenty-seven deaths were registered. A significant increase in WC was observed only in the non-survivor group. In the Cox regression analysis adjusting for sex, age, duration on dialysis, diabetes, BMI, serum albumin and C-reactive protein, high WC at baseline as well as the 6-month increase in WC were independently associated with mortality. This study demonstrated that a high WC and the increase over time in WC were both predictors of mortality in PD patients.

Avaliar o consumo de energia, proteína, fósforo e potássio de pacientes com doença renal crônica em hemodiálise. Materiais e Métodos: Foi realizado um estudo transversal com 34 pacientes em hemodiálise. Foi aplicado, por meio de entrevista, um questionário para a identificação das características clínico-demográficas dos pacientes. O método utilizado para a avaliação do consumo alimentar foi o registro alimentar de 3 dias. Os níveis séricos de fósforo e potássio e o valor do Kt/V foram obtidos por meio de consulta ao prontuário dos pacientes. Resultados: O consumo médio de energia, proteína, fósforo e potássio correspondeu a 19,0 kcal/kg, 0,9 g/kg, 612,5 mg e 1400,2 mg, respectivamente, sendo inferior às recomendações estabelecidas. A diferença na ingestão foi observada apenas pela variável sexo (p<0,05). Não houve correlação estatisticamente significativa entre a inadequação da diálise e o baixo consumo de nutrientes e entre o consumo de fósforo e potássio e seus níveis séricos. Conclusão: O consumo alimentar dos pacientes apresentou-se inadequado, ressaltando a necessidade de realização de medidas de educação nutricional para que a ingestão dos mesmos se adeque às recomendações e as comorbidades decorrentes do consumo inadequado sejam evitadas.