Fatores relacionados ao ganho de peso interdialítico em pacientes em hemodiálise

Abstract

Studies have shown that interdialytic weight gain (IDWG) of hemodialysis (HD) patients is influenced by many factors, a high IDWG negatively affecting the blood pressure (BP) of this population. To evaluate the relation of clinical, demographic and nutritional factors and the IDWG of HD patients. Cross-sectional study of 278 HD (54% males; age=54.4 ± 14.4 years) from 6 dialysis centers in the State of Santa Catarina, Brazil. The means of percentage interdialytic weight gain (%IDWG) and BP during a four-week period were calculated. Body mass index (BMI) and the 7-point subjective global assessment (SGA) scale were used to assess nutritional status. The means were: %IDWG 4.06 ± 1.55%, pre-HD BP 140 ± 50 / 99 ± 25 mmHg, and post-HD BP 110 ± 27 / 78 ± 10 mmHg. %IDWG inversely correlated with age and BMI and directly correlated with pre-HD systolic BP and time on HD. Women and patients without diabetes mellitus had higher %IDWG. Only the younger subgroup of patients with SGA-defined malnutrition had higher %IDWG than well-nourished ones. When malnutrition was BMI-defined, higher %IDWG was found in the whole study population and in the female and younger age subgroups. 24% of the patients had increased %IDWG (> 5%) and, when compared with those with adequate %IDWG, had inadequate and higher levels of systolic BP (144 ± 21 versus 138 ± 20 mmHg, p < 0.05), were younger and had lower BMI. These results showed that %IDWG of HD patients was influenced by gender, time on dialysis, age and nutritional status, and that high %IDWG adversely affected the BP of this population.