Avaliação do estado nutricional em pacientes renais crônicos em hemodiálise

Abstract

Aims: To assess the nutritional status and associated factors in chronic renal failure patients on hemodialysis. Methods: A cross-sectional study was conducted in a referral nephrology center at Hospital São Vicente de Paulo, in the city of Passo Fundo, Rio Grande do Sul state. Anthropometric evaluation consisted of weight (before and after the period of hemodialysis), body mass index, arm muscle circumference, arm muscle area, triceps skinfold thickness and thickness of the thumb muscle (these only after the period of hemodialysis). Biochemical tests included albumin, transferrin and cholesterol. The dietary recall was applied to total calories and protein. Results: Ninety patients were evaluated, of whom 70 (77.8%) men. Using body mass index, 38 patients (42.2%) were overweight, 45 (50%) were normal and 7 (7.8%) were underweight after dialysis. Overweight was estimated in 18 (20%) patients by triceps skinfold and in no patient by the other anthropometric measures used. Nutritional depletion was identified in 53 patients (58.9%) using the triceps skinfold, in 37 (41.1%) by arm muscle circumference, in 72 (80%) by arm muscle area and in 84 (95.4 %) by albumin dosage. Dietary intake of energy and protein intake were below the reference standards and were significantly lower in patients with overweight. Conclusions: There was a high prevalence of overweight assessed by body mass index, whereas most patients had nutritional depletion in other anthropometric variables, with concomitant decrease in albumin and lean body mass, after the period of hemodialysis.