Correlation of nutritional status and food intake in hemodialysis patients.
BACKGROUND
Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group.


METHODS
Stable patients undergoing chronic hemodialysis for at least 3 months (n=44) were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0+/-16.9 years, and 63.6% were men. Body mass index was 22.2+/-3.9 kg/m2 (mean+/-SD), calorie intake was 1471+/-601 kcal/day (20.7+/-6.7 kcal/kg/day), and protein ingestion was 74.3+/-16.6 g protein/day (1.2 g/kg/day). Dietary and clinical findings were correlated with nutritional indices by linear regression analysis.


RESULTS
Malnutrition estimated by subjective global assessment was very common (>90%), despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yielded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02). Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis) (P<.001).


CONCLUSIONS
1) Bioimpedance analysis was useful and was correlated with clinical findings; 2) Lipid intake was the best dietary index in this experience, surpassing protein or total energy; 3) Despite its shortcomings, dietary recall was useful in the assessment of hemodialysis patients.
Morais
Alvaro A C
AA
Nutrition Support Service and Hemodialysis Unit, Santa Rita de Cassia Hospital and Faculty of Medical Sciences of Santa Casa, Vitória/ES, Brazil.
Silva
Maria A T
MA
Faintuch
Joel
J
Vidigal
Erica J
EJ
Costa
Rozilene A
RA
Lyrio
Daniele C
DC
Trindade
Celia R
CR
Pitanga
Karoline K
KK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004435:Eating; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000209:etiology; D009752:Nutritional Status; D011446:Prospective Studies; D006435:Renal Dialysis; D012720:Severity of Illness Index