Estado nutricional del paciente en hemodiálisis y factores asociados

Abstract

Introduction: Malnutrition in chronic dialysis patients has a high prevalence and important repercussion in morbidity and mortality. Since there are no previous studies in our service, we propose a study whose objective is to evaluate the nutritional status and associated factors. Material and Method: A descriptive, observational, cross-sectional study, in the second trimester of 2015, in patients in the hemodialysis program of a county hospital. Age, sex, Charlson’s index, dialysis technique, BMI, time on dialysis, albumin, CRP, cholesterol and serum transferrin were recorded. Subjective global assessment and Score Malnutrition Inflammation were used as instrument. Results: We analyzed 35 patients, mean age was 72.2 years (SD: 11.8), 34.3% were women, BMI was 27.1 (SD: 4.9), Charlson index 6.4 (DS: 1.7), 77.1% were on conventional dialysis and 22.9% were on-line hemodiafiltration. Regarding the MIS test, 46% had good nutritional status and 54% were malnourished. According to the VGS, 66% had good nutritional status, 31% risk of malnutrition and 3% severe malnutrition. VGS was related to BMI (p: 0.02), creatinine (p: 0.001), total cholesterol (p: 0.02), and CRP (p: 0.01); and it was not related to age, time on hemodialysis, Charlson’s index, transferrin and albumin (p> 0.05). The Score Malnutrition Inflammation (MIS) was related to BMI (p: 0.002), Charlson’s index (p: 0.01), creatinine (p: 0.009) and CRP (p: 0.02); not with age, time on hemodialysis, total cholesterol, transferrin and albumin (p> 0.05). Conclusions: There is good correlation between the two tools and analytical parameters used. Patients in on-line hemodiafiltration have good nutritional status. There is no single parameter that evaluate nutrition. The inclusion of nutritional assessment is suggested given the high prevalence.