[Factors predisposing to malnutrition development in the patients on maintenance hemodialysis].
Malnutrition of maintenance hemodialysis patients is a serious clinical problem, strongly and negatively affecting their outcome. However, very few studies are available concerning assessment of nutritional state and its predisposing factors in the Polish hemodialysed patient population. Included were 103 patients: 49 man and 54 woman (aged 48.57 years), on maintenance hemodialysis for an average of 71.46 +/- 64.3 months. They were subjected to anthropometry, SGA scale and biochemical evaluation. Simultaneously we calculated dialysis adequacy indicators. Then we compared obtained results with anthropometrical and biochemical norms and results obtained from the group of 29 healthy volunteers. Hemodialysed patients have been significantly underweight (62.51 vs. 73.55 kg in controls). Muscle mass loss dominated: AMA/50 centile AMA in the patients vs. controls have been 75.75 vs. 99.3%. Analysing body weight after dialysis to standard body weight (obtained from anthropometric data) ratio of 5.8% of patients were severely malnourished, 60.2% moderately malnourished. Analysing the patient study group 8.4% had albumin < 35 g/l and 33.3% prealbumin < 0.3 g/l. Only 34% achieved 10-12 points in the SGA scale. Normalized pcr < 1.2 g/kg/day was obtained in 54.4% patients. In the elderly we observed malnutrition more frequently than in the younger population. When pcr increases, also LBM and albumin level in blood increases. The patients who had metabolic acidosis revealed higher pcr and lower albumin. We did not find any relationship between Kt/V and AMA, LBM or albumin. The patients, who were underdialysed revealed lower prealbumin levels.
Kraśnicka
Monika
M
Katedra i Klinika Nefrologii, Collegium Medicum, Uniwersytetu Jagielloriskiego w Krakowie. monikakrasnicka@poczta.onet.pl
Sułowicz
Władysław
W
Kopeć
Jerzy
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006437:Hemodialysis, Home / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013997:Time Factors
D012709:Serum Albumin