NUTRITIONAL-STATUS IN THE ELDERLY PATIENT WITH UREMIA

An increasing number of elderly patients with uraemia are treated by d ialysis therapy. Virtually every published study on nutritional status of patients undergoing maintenance haemodialysis treatment or continu ous ambulatory peritoneal dialysis (CAPD) has indicated that a substan tial proportion of patients undergoing regular dialysis treatment have protein calorie malnutrition. Problems of undernutrition increase sig nificantly with age; a combination of socioeconomic, psychological, an d biochemical problems interfering with acquiring and assimilating a b alanced diet are responsible for nutritional deficiencies in older peo ple. We assessed the prevalence of protein calorie malnutrition in 183 regular dialysis patients aged 65 years or older treated with haemodi alysis or CAPD. This group of patients was compared to two other group s aged 18-40 years (62 patients) and 41-64 years (239 patients). Prese nce of malnutrition was assessed by selected serum chemistries, anthro pometry and Subjective Global Nutritional Assessment. Adequacy of dial ysis, protein nitrogen appearance, as an index of protein intake, and residual renal function were measured. The results indicate that prote in calorie malnutrition occurs commonly in regular dialysis patients, with a higher prevalence of malnutrition in the elderly; 51% of patien ts of the elderly group were classified as malnourished, and no differ ence was found with the two dialytic modalities.