Abstract

GUTIERREZ MARTIN, Carmen; MAYORAL PENAS, Azucena  and  VELASCO BALLESTERO, Sonia. Prevalence and detection of malnutrition in patients on dialysis in the General Hospital of Segovia. Rev Soc Esp Enferm Nefrol [online]. 2009, vol.12, n.4, pp.14-21. ISSN 1139-1375.

Malnutrition is one the most powerful independent predictors of morbimortality in patients on chronic dialysis. Inflammation, hypercatabolism associated to the dialysis procedure, comorbidities and reductions in protein and calories ingestion are though to be the main causes of malnutrition in those patients. The availability of an ideal (sensible, easy to measure, and reproducible) malnutrition marker, is difficulties by the metabolic changes associated to chronic renal failure. To know the nutritional status of a patient, in order to make individual nutritional recommendations, it is necessary to use a panel of anthropometric, biochemical and dietary measurements; on the other hand, bioelectrical impedance vector analysis has been validated for its use in patients on hemo and peritoneal dialysis and might be helpful for the early detection of nutritional alterations. In this study we evaluated the prevalence of malnutrition in 43 stable dialysis patients, using classical biochemical and anthropometrics parameters, as well as dietary surveys, and bioelectrical impedance vector analysis. According to biochemical parameters, 41,9% to 53% of our patients showed malnutrition, whereas using anthropometrics parameters only 26% were malnourished. Bioelectrical impedance vector analysis demonstrated that 18,6 % of patients showed a reduction on total body fat. Anthropometric and bioimpedance muscle parameters were within normal range in most patients. Patients with an adequate protein-calorie ingestion did not showed better nutritional parameters than the rest, in terms of biochemical and body composition values, so we think that more than a problem of ingestion, malnutrition in these patients is the result of infl ammation and hypercatabolism.

Keywords : Nutrition; Dialysis; Caloric Ingestion; Protein Ingestion; Anthropometric Parameters; Bioelectrical Impedance Vector Analysis.

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