Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis

Abstract

CONTEXT AND OBJECTIVE: Patients with chronic kidney failure undergoing dialysis have high prevalence of protein-energy malnutrition. There is still no uniform method for assessing these patients' nutritional status. It is recommended that a set of subjective and objective methods should be applied so that an adequate nutritional diagnosis can be reached. The aim of this study was to evaluate the nutritional profile of patients undergoing hemodialysis. DESIGN AND SETTING: Cross-sectional study conducted in the Dialysis Treatment Unit, Araraquara, São Paulo, Brazil, in 2008. METHODS: Anthropometric and biochemical indicators were characterized for 48 patients who also gave responses to the modified Subjective Global Assessment questionnaire (SGAm), and possible correlations between these indicators were investigated. RESULTS: The frequency of moderate or severe malnutrition ranged from 22% to 54%, according to the parameter used. Regarding the patients' conformity with the ideal weight, 29% of them weighed less than 75% of the ideal, and thus were classified as having moderate or severe malnutrition. The most significant correlations were observed between body mass index (BMI) and the idealness of triceps skinfold (TSF), upper arm circumference (UAC) and upper arm muscle circumference (UAMC); and between SGAm and the idealness of UAC and UAMC. CONCLUSION: The frequency of malnutrition showed great variability among the patients, according to the evaluation criterion chosen. Routine nutritional monitoring and validation of methods for assessing body composition among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.RESUMO CONTEXTO E OBJETIVO: Portadores de insuficiência renal crônica em diálise apresentam alta prevalência de desnutrição proteico-energética. Não existe ainda um método uniforme para avaliar o estado nutricional desses pacientes. Recomenda-se a aplicação de um conjunto de métodos subjetivos e objetivos para se chegar aos diagnósticos nutricionais adequados. O objetivo deste estudo é traçar o perfil nutricional de pacientes submetidos a hemodiálise. TIPO DE ESTUDO E LOCAL: Estudo transversal descritivo realizado na Unidade de Tratamento Dialítico de Araraquara, São Paulo, Brasil, em 2008. MÉTODOS: 48 pacientes tiveram seus indicadores antropométricos e bioquímicos caracterizados, sendo também submetidos ao questionário Avaliação Global Subjetiva modificada (SGAm), verificando-se possí-veis correlações entre esses indicadores. RESULTADOS: A frequência de desnutrição moderada e grave variou de 22% a 54%, de acordo com o parâmetro utilizado. Com relação à adequação do peso ideal, 29% da amostra estavam com porcentagem de adequação abaixo do percentil 75, classificados como portadores de desnutrição moderada e grave. As correlações mais significativas foram observadas entre índice de massa corporal (IMC) e adequações de prega triciptal (PCT), circunferência do braço (CB) e circ...

Subjective global assessment for nutritional assessment of hospitalized patients requiring haemodialysis: A prospective cohort study

“…Anthropometric measurements including percentage of usual body weight, percentage of standard body weight and BMI, are valid indicators of nutritional status in maintenance haemodialysis patients . This study showed a correlation between BMI and SGA status, which is in agreement with studies done by others as well . The mean BMI (27.3 kg/m 2 ) for SGA‐A category was in the overweight range while the mean BMI in SGA‐B and SGA‐C were in the ‘normal range’ and ‘underweight’ categories, respectively.…”

Relationship Between Leptin Level, Inflammation, and Volume Status in Maintenance Hemodialysis Patients

“…Normovolemic patients in our study cohort had a shorter time on dialysis and better preserved residual renal function and nutritional status, as represented by higher BMI and FTI. Consistent with these findings, previous studies reported an association between hypervolemia, longer time on dialysis, lower BMI, serum albumin, and fat tissue index in HD patients, as well as a positive correlation between BMI and FTI .…”

Nutritional status of haemodialysis patients: Comparison of Australian cohorts of Aboriginal and European descent

“…Subjects were excluded if they became medically unstable or died over the 3‐month data collection period. Data were collected during the winter months (June–August) in 2011 while subjects underwent routine haemodialysis treatment, anthropometry and biochemical assays . Weight was taken during the first three haemodialysis treatments each month and averaged to obtain the pre‐dialysis and post‐dialysis weight recorded.…”