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Nutrición Hospitalaria

On-line version ISSN 1699-5198Print version ISSN 0212-1611

Nutr. Hosp. vol.32 n.3 Madrid Sep. 2015 



Inflammatory, nutritional and clinical parameters of individuals with chronic kidney disease undergoing conservative treatment

Inflamación, estado clínico y nutricional de pacientes renales crónicos en tratamiento conservador



Alessandra Fortes Almeida1, María Helena Lima Gusmão-Sena2, Layne Carla Gonzaga Oliveira3, Tarcisio Santana Gomes3, Thais Vitorino Neves do Nascimento3, André Luiz Nunes Gobatto4, Lilian Ramos Sampaio5 and Jairza María Barreto-Medeiros6

1Master's degree in Food, Nutrition and Health, Federal University of Bahia.
2Master's degree in Food, Nutrition and Health, Federal University of Bahia; Assistant professor, School of Nutrition, Federal University of Bahia.
3Specialist in Clinical Nutrition, Residency program in Clinical Nutrition, School of Nutrition, Federal University of Bahia, Bahia.
4Medical Intensive Care Unit, Emergency Department, Hospital of Clinical, University of São Paulo Medical School, São Paulo.
5PhD (Nutrition), Federal University of São Paulo; Adjunct professor, School of Nutrition, Federal University of Bahia, Bahia.
6PhD in Nutrition, Federal University of Pernambuco; Adjunct professor, School of Nutrition, Federal University of Bahia, Brazil.




Introduction: due to the relevance of inflammation in individuals with chronic kidney disease (CKD), inflammation should be taken into account in the interpretation of the clinical-nutritional status.
Objective: assess the association between inflammation, nutritional and clinical parameters in patients with CKD.
Materials and methods: 92 patients with CKD. C-reactive protein (CRP) was used as an inflammation marker. Assessed nutritional parameters were anthropometry and biochemical exams. Evaluated clinical parameters were comorbidities, CKD characteristics, lipid profile, lipid-lowering agents, urea, creatinine and total leukocytes. Comparisons between two groups (with or without inflammation) were performed using Studentfs t-test or chi-square test.
Results: 15 (16.3%) patients had CRP above ≥ 10mg/L and were considered with inflammation. In the group with inflammation, 05 (33%) had hypoalbuminemia as compared with 05 (6.5%) in the group without inflammation (p = 0.002). Lipid values were lower in the group with inflammation, with mean total cholesterol 171 (± 41.2) mg/dL and mean LDL-C 95 (± 31.2) mg/dL as compared with the group without inflammation, which had and a mean total cholesterol 198 (± 46) mg/dL and mean LDL-C 124 (± 40.1) mg/dL, p = 0,038 and p = 0.011, respectively. No other statistically significant differences between groups were found.
Conclusion: inflammation was associated with changes in the total cholesterol and LDL levels and with an increased incidence of hypoalbuminemia. We suggest that serum albumin levels should only be used to assess nutritional status in the absence of inflammation and CRP levels ought to be considered in nutritional status interpretation in patients with CKD.

Key words: Chronic kidney disease. C-reactive protein. Inflammation. Nutritional status. Hypoalbuminemia.


Introduccion: la inflamacion es un problema frecuente en pacientes con enfermedad renal cronica (ERC) y se debe relacionar con el estado clinico y nutricional de estos.
Objetivo: evaluar si existe una asociacion entre la inflamacion y los parametros clinicos y nutricionales en los pacientes con ERC.
Material y metodos: fueron evaluados 92 pacientes con ERC. Se utilizo la proteina C reactiva (PCR) como marcador de la inflamacion. Los parametros nutricionales evaluados fueron antropometria y examenes bioquimicos. Los parametros clinicos evaluados fueron comorbilidades, caracteristicas de la ERC, perfil lipidico, hipolipemiantes, urea, creatinina y leucocitos totales. Para analizar las diferencias entre los grupos (con o sin inflamacion) se utilizo el test t de Student o el test de Chi-cuadrado.
Resultados: 15 pacientes (16,3%) presentaban PCR ≥ 10,0 mg/dL y tenian inflamacion. De estos, 05 (33%) tuvieron hipoalbuminemia, en comparacion con 05 (6,5%) en el grupo sin inflamacion (p = 0,002). Los valores de lipidos fueron inferiores en el grupo con inflamacion, con colesterol total medio de 171 mg/dL (± 41,2) e LDL-C medio de 95 mg / dL (± 31,2) en comparacion con aquellos sin inflamacion con medias de 198 mg / dL (± 46) y 124 mg/dL (± 40,1), respectivamente. No se encontraron otras diferencias significativas entre los grupos.
Conclusion: la inflamacion se ha asociado con modificaciones en el colesterol total, LDL e hipoalbuminemia. Se concluye que la albumina serica solo se debe utilizar para evaluar el estado nutricional en ausencia de inflamacion. El nivel de PCR es un marcador sensible de la inflamación y debe ser empleado en la interpretación del estado nutricional en pacientes con ERC.

Palabras clave: Enfermedad renal crónica. Proteína C reactiva. Inflamación. Estado nutricional. Hipoalbuminemia.

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