Estado nutricional e ganho de peso interdialítico de pacientes com doença renal crônica em hemodiálise

Abstract

Introduction: The nutritional status (NS) of patients on hemodialysis (HD) is a major concern and challenge. Malnutrition is common in these patients and is related to poorer clinical outcomes. Objectives: To assess the association between the NS and the interdialytic weight gain (IDWG) of patients with chronic kidney disease (CKD) on HD. Methods: Crosssectional study with 322 patients older than 18 years. The NS was assessed by body mass index (BMI), percentage body fat estimated by the sum of four skinfolds (triceps, biceps, subscapular and supra iliac), lean body mass (LBM), serum creatinine and albumin and rate of nitrogen appearance (PNA). The IDWG was evaluated from the sum of the weight difference of 12 hemodialysis sessions (IDWGm). Results: Considering the sample into quartiles IDWGm, it was found that BMI, LBM, serum creatinine (p < 0.001) and PNA (p = 0.011) were directly correlated. There was no association between IDWGm and serum albumin. Using multivariate analysis, it was found that the prevalence of patients with BMI suitability and serum creatinine were significantly higher for patients in the bottom quartile with respect to the first IDWGm. Conclusion: The NS is positively associated with IDWG. The results point to the need for individualized assessment of IDWG and cautious in order not to generalize a recommendation that does not meet the expectations of maintaining and promoting the nutritional status of these patients.