Nutritional Assessment In Hemodialysis Patients : Influence of Method and Sex

Abstract

Introduction: Several nutritional assessment methods are available. The objective of this study was to assess the nutritional status of chronic hemodialysis patients based on anthropometry, bioimpedance and albuminemia. Patients and Method: A cross-sectional study was conducted in two hemodialysis units, having included patients regularly on dialysis, with no history of hospitalization during the last month and consenting. The nutritional evaluation was based on the collection of anthropometric markers, the determination of body composition by bioelectrical impedance analysis and the determination of albuminemia. Results: 68 hemodialysis patients (46.7 years old, 51.5% women) analyzed. The prevalence of undernutrition was 47.1% (95% CI [34.8 – 59.6]) according to BMI, 25% (95% CI [15.3 – 37.0]) according to brachial circumference, by 10.3% (95% CI [4.2 – 20.1]) according to the percentage of ideal weight, by 11.8% (95% CI [5.2 – 21.9]) according to the FM, by 55.9% (95% CI [43.3 – 67.9]) according to the LM index and by 10.3% (95% CI [4.2 – 20.1]) according to serum albumin . Similarly, the prevalence of obesity varied from 8.8% (95% CI [-1.8 – 22.4]) according to BMI and from 36.8% (95% CI [24.7 – 48 ,9]) according to the FM. According to bioimpedance, women on hemodialysis were more exposed to malnutrition than men. Impedance nutritional parameters were thus strongly correlated and agreement with anthropometric parameters in the diagnosis of undernutrition and obesity. Conclusion: Due to its availability and simplicity, bioelectrical impedance analysis (BIA) has considerable potential as a complement to conventional anthropometric techniques for assessing the nutritional status of hemodialysis patients.