title: Gastrointestinal symptoms and nutritional status in women and men on maintenance hemodialysis.
abstract: OBJECTIVE
  The main objective was to investigate whether the prevalences of nausea, vomiting, diarrhea, and reduced appetite varied by gender in maintenance hemodialysis (MHD) patients. We also evaluated whether these symptoms explain female-male difference in nutritional status.
  
  
  METHODS
  Cross section of baseline data of the Prospective Study of the Prognosis in Chronic Hemodialysis Patients.
  
  
  METHODS
  Dialysis units in the city of Salvador, Brazil.
  
  
  METHODS
  Three hundred ninety-seven men and 287 women with more than three months on MHD.
  
  
  METHODS
  Gender.
  
  
  METHODS
  The patient's self-reported nausea, vomiting, diarrhea, and reduced appetite. The malnutrition-inflammation score (MIS) was used to assess nutritional status.
  
  
  RESULTS
  The prevalence of symptoms was 24.3% for reduced appetite, 19.7% for nausea, 12.3% for vomiting, and 3.5% for diarrhea. In a logistic regression model with adjustments for age, diabetes, congestive heart failure, hemoglobin, albumin, Kt/V, and years on dialysis, women were found to have significantly higher odds of reduced appetite (odds ratio [OR] = 1.97), nausea (OR = 1.90), and vomiting (OR = 2.21). MIS was 5.41 ± 3.18 for women and 4.66 ± 3.28 for men (P = .002) corresponding to a percentage difference of 13.86%. The female-male difference reduced by more than half after excluding the gastrointestinal symptoms component and by approximately 65% after excluding both the gastrointestinal symptoms and the dietary intake components from the MIS.
  
  
  CONCLUSIONS
  The results suggest that the prevalences of nausea, vomiting, and reduced appetite are higher in women than in men on MHD. These gastrointestinal symptoms and perhaps their detrimental effects on dietary intake may partially explain a poorer nutritional status in MHD women.
authors.affiliation: Núcleo de Epidemiologia Clínica, Hospital Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Luciana Ferreira
authors.initials: LF
authors.lastname: Silva
authors.forename: Gildete Barreto
authors.initials: GB
authors.lastname: Lopes
authors.forename: Cácia Mendes
authors.initials: CM
authors.lastname: Matos
authors.forename: Katherine Quadros
authors.initials: KQ
authors.lastname: Brito
authors.forename: Maurício Kauark
authors.initials: MK
authors.lastname: Amoedo
authors.forename: Matheus Freitas
authors.initials: MF
authors.lastname: Azevedo
authors.forename: Meiry Jane
authors.initials: MJ
authors.lastname: Sá Araújo
authors.forename: Márcia Silva
authors.initials: MS
authors.lastname: Martins
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Lopes
mesh_terms: D000328:Adult; D000368:Aged; D001066:Appetite; D001938:Brazil; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D009752:Nutritional Status; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D057566:Self Report; D012737:Sex Factors; D014839:Vomiting / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology