title: Dyspepsia is Associated with Low Protein and Caloric Intake among End-Stage Renal Disease Patients.
abstract: BACKGROUND
  Dyspepsia is highly prevalent and easily assessed in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) and is not a traditional predictor of malnutrition. We sought to establish an association between dyspeptic symptoms and nutritional status in ESRD patients undergoing maintenance HD.
  
  
  METHODS
  We studied 106 ESRD patients on HD. Dyspepsia was assessed through the Porto Alegre Dyspeptic Symptoms Questionnaire (PADYQ). Scores equal to or greater than 6 classified patients as dyspeptic. Nutritional status was evaluated using serum chemistry, total body mass, muscle mass, and dietary intake. Nutritional status was compared between dyspeptic and non-dyspeptic patients. The association of PADYQ scores and the presence of dyspepsia with nutritional variables were tested. Multivariate analysis was performed to test dyspepsia as an independent predictor for dietary intake.
  
  
  RESULTS
  There were 41 (38.7 %) dyspeptics. Protein intake (g/kg/day) and calorie intake (kcal/kg/day) were lower among dyspeptics compared to non-dyspeptics, 1.0 ± 0.5 vs 1.3 ± 0.5 (p = 0.01) and 23.0 ± 9.2 vs 27.4 ± 10.0 (p = 0.02), respectively. More dyspeptics than non-dyspeptics presenting protein-energy wasting based on protein and calorie intake, 41.4 vs 15.3 % (p = 0.01) and 68.2 vs 38.4 % (p = 0.02), respectively. PAQYQ score was negatively correlated with protein intake (r = - 0.20; p = 0.03) and calorie intake (r = - 0.19; p = 0.04). Dyspepsia was able to predict protein (b = - 0.26; p = 0.01) and calorie (b = - 4.42; p = 0.02) intake.
  
  
  CONCLUSIONS
  Dyspepsia is associated with low protein and calorie intake. Screening of dyspeptic symptoms can be routinely performed aiming to improve HD patients' nutritional status.
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.|2 Dialysis Unit, Santa Casa Hospital, Sobral, Ceará, Brazil.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Santos
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Diego Levi
authors.initials: DL
authors.lastname: Silveira Monteiro
authors.affiliation: 2 Dialysis Unit, Santa Casa Hospital, Sobral, Ceará, Brazil.
authors.forename: Paulo Henrique Alexandre
authors.initials: PH
authors.lastname: de Paula
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Vicente
authors.initials: V
authors.lastname: Lopes Monte Neto
authors.affiliation: 2 Dialysis Unit, Santa Casa Hospital, Sobral, Ceará, Brazil.
authors.forename: Maria Leilah
authors.initials: ML
authors.lastname: Ponte Monte Coelho
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Cecília
authors.initials: C
authors.lastname: Costa Arcanjo
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lopes Ponte Neto
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Marcela
authors.initials: M
authors.lastname: Lopes Lima
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Natacha
authors.initials: N
authors.lastname: Campos Arriaga
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Lília
authors.initials: L
authors.lastname: Mendes Vieira Coêlho
authors.affiliation: 1 School of Medicine, Sobral Campus, Federal University of Ceará, Brazil.
authors.forename: Wallena
authors.initials: W
authors.lastname: Cavalcante Brito
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D004415:Dyspepsia / Q000209:etiology*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000473:pathology*; D012307:Risk Factors
chemical_list: D004044:Dietary Proteins
keywords: dietary intake; dyspepsia; end-stage renal disease; hemodialysis; nutrition; protein-energy wasting