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Introduction: There are several factors involved in the development of malnourished patients under hemodialysis. Due to the impact of malnourished patients in prognosis, it is very important to supervise the protean energetic status of these patients.
Objective: Evaluate the nutritional status of patients with chronic renal disease (CKD 5) stage 5 under hemodialysis management (HD).
Methods: Patients older than 18 years old, female and male who underwent dialysis three times a week were included. As nutritional diagnosis, Subjective Global Assessment (SGA modified by Kalantar), Body Mass Index (BMI), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), and biochemical parameters (albumin, cholesterol, protein catabolic rate, phosphorus).
Results: According to SGA, 5% of the patients presented moderate malnutrition, according to BMI, 28% presented malnutrition, according to TSF, 12% presented depletion of fat mass, being significantly higher in female sex (p=0,015). According to MAMC, 42% presented wasting of its muscular mass, being significantly higher in male sex (p=0,029). According to albumin values, 41% presented nutritional risk and according to cholesterol values, the 55%. 75% presented unsuitable protein intake. MAMC wasting was significantly correlated with low protein intake (p=0,02). 62% of the population presented altered phosphorus values.
Conclusions: From the present study it is inferred that there is not a unique method of nutritional evaluation and that it is necessary to combine subjective and objective methods to identify those patients that require specific nutritional intervention.
Translation - Spanish Título: Evaluación del estado nutricional en pacientes con insuficiencia renal crónica en tratamiento de hemodiálisis.
Autores: Maria Clara Onel, Maria Inés García, Liliana Andrade, J Perez Loredo, Ricardo Martinez
Institución: Hospital Churruca-Vizca
E-mail: [email protected]
Resumen
Introducción: Varios son los factores implicados en el desarrollo de la malnutrición de los pacientes en hemodiálisis, Dado el impacto de la desnutrición en el pronóstico, es de suma importancia supervisar el estado energético proteico de estos pacientes.
Objetivo: Valorar el estado nutricional de los pacientes con enfermedad renal crónica (ERC5) estadio 5 en tratamiento de hemodiálisis (HD)
Metodología: Se incluyeron pacientes mayores de 18 años, de ambos sexos, que realizaran diálisis trisemanal. Como diagnóstico nutricional se utilizó la Valoración Global Subjetiva (VGS modificada por kalantar), Indice de Masa Corporal (IMC), el pliegue tricipital (PT), Circunferencia muscular del brazo (CMB), y parámetros bioquímicos (albúmina, colesterol, índice de catabolismo proteico, fósforo).
Resultados: Según la VGS, el 5% de los pacientes presentó desnutrición moderada, según el IMC el 28 % presentó desnutrición, según el PT un 12 % presentó depleción de su masa grasa, siendo significativamente mayor en el sexo femenino (p=0.015). Según la CMB el 42 % presentó depleción de su masa muscular, siendo significativamente mayor en el sexo masculino (p=0.029). Según los valores de albúmina el 41 % presentó riesgo nutricional y según los valores de colesterol el 55 %. El 75 % presentó ingesta proteica inadecuada. La depleción de la CMB se correlacionó significativamente con la baja ingesta proteica (p=0.02). El 62 % de la población presentó valores de fósforo alterados.
Conclusiones: Del presente estudio se infiere que no existe un único método de valoración nutricional y es necesario una combinación de métodos subjetivos y objetivos para lograr identificar a aquellos pacientes que requieran de intervenciones nutricionales específicas.
Introduction: Several factors involved in the development of malnutrition in hemodialysis patients, given the impact of malnutrition in the forecast, it is extremely important to monitor the protein energy status of these patients.
Objective: To assess the nutritional status of patients with chronic kidney disease (ERC5) stage 5 on hemodialysis (HD)
Methods: Patients over 18 years, of both sexes, tri-weekly dialysis. Nutritional diagnosis was used as the Subjective Global Assessment (SGA), body mass index (BMI), triceps skinfold (PT), arm muscle circumference (AMC), and biochemical parameters (albumin, cholesterol, protein catabolic rate, phosphorus ).
Results: According to SGA, 5% of patients had moderate malnutrition by BMI 28% had malnutrition, according to the PT showed 12% depletion of their fat mass and was significantly higher in females (p = 0.015). According to the AMC showed 42% depletion of their muscle mass and was significantly higher in males (p = 0.029). According to the values of albumin, 41% were at nutritional risk and cholesterol levels by 55%. The 75% had inadequate protein intake. AMC depletion was significantly correlated with low protein intake (p = 0.02). 62% of the population showed altered phosphorus values.
Conclusions: From this study it appears that no single method of nutritional assessment and need a combination of subjective and objective methods in order to identify those patients who require specific nutritional interventions.
English-Spanish Interpreter and Translator. 28 years experience. Recomendation letters from Switzerland, UK, USA, Brasil, Dominican Republic and Argentina.Online Spanish Teacher. Proofreader. Online Spanish Teacher and Online English Teacher.
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