Resumo

ORDONEZ PEREZ, V. et al. Nutritional status in chronic renal failure patients assisted at the hemodialysis program of the "Hermanos Ameijeiras" Hospital. Nutr. Hosp. [online]. 2007, vol.22, n.6, pp.677-694. ISSN 1699-5198.

Introduction: Heterogeneity of malnutrition rates associated with End-Stage Renal Disease (ESRD) under Haemodialysis (HD) points towards differing performances of the used indicators. Objectives: To identify those indicators that better describe the nutritional state of the patient with ESRD under HD. Setting: Program of Haemodialysis, Service of Nephrology, "Hermanos Ameijeiras" Hospital (Havana City, Cuba). Methods: Twenty-eight patients were recruited. Hospital admissions between december 2001-december 2002 were recorded. The condition of the patient (alive/deceased) after one year of observation was registered. The Subjective Global Assessment (SGA) form was administered to each patient. The nutritional profile included: height, weight, mid-arm circumference (MAC), triceps skinfold (TSF), albumin and total lymphocyte count (TLC). Nutritional status as described by means of albumin and MAC was correlated with SGA score, the ocurrence of hospital admissions and the final condition of the patient. Results: Malnutrition rates were as follows (albumin < 35 g/L): 42.9%; (MAC < cut-off value): 60.7%; [(MAC < cut-off value) and/or (albumin < 35)]: 71.4%; (SGA score = At Risk/Malnourished): 42.9%. SGA score was an independent predictor of the ocurrence of admissions [OR = 14.14; CI 95%: 1.5-137.3] and mortality [OR = 21.0; CI 95%: 2.9-151.4]. Serum albumin was an independent predictor of the patient's mortality [OR = 21.0; CI 95%: 2.9-151.4]. The [(MAC < Cut-off value) and/or (albumin < 35)] rule failed to predict patient's morbimortality. Seventy-seven point eight percent of patients with +60 years-old died during the year of observation [OR = 13.2; IC 95%: 1.9-89.5]. Conclusions: Increased mortality associated with diminished values of albumin and MAC justifies the fostering of nutritional intervention aimed to preserve lean tissues.

Palavras-chave : End-stage renal disease; Haemodialysis; Nutritional assessment; Subjective global assessment; Malnutrition; Serum albumin; Mid-arm curcumference.

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