Does nutrition play a role in the quality of life of patients under chronic haemodialysis?
BACKGROUND
In patients with chronic renal failure under haemodialysis, we investigated the inter-relationships and relative contributions of disease, haemodialysis and of nutrition related factors on the patients' Quality of Life.


METHODS
Collected data in 60 adult patients comprised: co-morbidities (multiple medicines, other chronic diseases), duration of renal failure and of haemodialysis (in months), % weight loss since haemodialysis, nutrient intake derived from diet history analysis (DIETPLAN5 2003, UK). The EuroQoL instrument that includes 5 dimensions, mobility, self-care, activities, pain/discomfort, anxiety/depression, and an overall health visual analogue scale evaluated QoL.


RESULTS
Estimates of effect size attributed to each variable included in the general linear model revealed that 47% of patients' mobility/self-care scores were worsened by deficient protein/energy intake and 30% by weight loss =10%. Poor performance of usual activities was attributed in 45% to duration of haemodialysis and of disease, 70% to protein/energy/vitamin B12/zinc/iron deficits, and 20% to weight loss =10%. Pain/discomfort were worsened in 45% by the duration of haemodialysis and of disease, and in 15% by co-morbidities. Higher anxiety/depression were related in 43% to protein/energy/selenium & vitamin C deficits, in 40% to the duration of haemodialysis and of disease, in 10% to weight loss =10%, and in 3% to co-morbidities. Likewise, 47% of poor overall health was determined by protein/energy/vitamin B12/ zinc/selenium & vitamin C deficits, 25% by weight loss =10%, 10% by disease duration, and 7% by co-morbidities.


CONCLUSIONS
Protein, antioxidants and key micronutrients involved in protein metabolism, did exert a major effect on patients' Quality of Life. Given the prevalence of nutrient deficits, the ensuing impaired functional capacity is likely to compromise QoL, timely nutrition is thus warranted.
Raimundo
P
P
Unit of Nutrition and Metabolism, Institute of Molecular Medicine, Faculty of Medicine of the University of Lisbon, Portugal.
Ravasco
P
P
Proença
V
V
Camilo
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D011788:Quality of Life; D006435:Renal Dialysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires