Relação entre eficiência da hemodiálise e estado nutricional em pacientes com doença renal crônica

Abstract

AIMS: To verify the relationships between the dialysis adequacy index (Kt/V) and nutritional parameters of individuals with chronic renal disease on hemodialysis.METHODS: A retrospective study was performed at a hemodialysis institute. Data on sex, age, biochemical tests, dry weight, height, arm circumference (AC) and triceps skin fold (TSF) were collected from the medical charts. Nutritional risk index (NRI), body mass index (BMI), arm muscle circumference (AMC), corrected arm muscle area (AMAc), Kt/V and urea reduction rate (URR). The Mann-Whitney test and the Spearman correlation were used for the statistical analysis, and a p<0.05 was considered significant.RESULTS: A total of 164 patients were evaluated, with a mean age of 58±14.4 years, of which 96 (59%) were male. The median time on hemodialysis was 35.0 (5-234). Among the 164 patients, 60 (37%) presented nutritional risk. In the evaluation of nutritional status, the mean values obtained were 25.0±4.5 kg/m2 for BMI, 99.0±12.3% for CB adequacy, 86.7±14.5% for WBC adequacy, 122.9±66.8% for CBA adequacy and 1.4±0.4 for Kt/V. The median adequacy for PCT was 107.8% (11.5%-305.4%). There was no correlation of Kt/V with serum albumin, CB, CMB, AMAc and NRI. Kt/V had a low positive correlation with time on hemodialysis (r = 0.2197) and a low negative correlation with PCT (r = -0.1692) and with BMI (r = -01970). The correlation between Kt/V and dry weight was moderate and negative (r = -0.3710) and between Kt/V and URR the correlation was strongly positive (r = 0.81129).CONCLUSIONS: Adequate dialysis efficiency and good nutritional status were observed in most patients of the evaluated sample, with significant correlations between dialysis adequacy and parameters of nutritional status assessment.