COOPERATIVE STUDY OF NUTRITION IN HEMODIA LYSIS .2. PREVALENCE OF PROTEIN-CALORIE MALNUTRITION IN HEMODIALYSIS-PATIENTS

The nutritional status has been evaluated in 760 out of 870 hemodialys is patients from several dialysis units, by anthropometric and biochem ical parameters. Patients without anthropometric parameter assessment were excluded. There were 422 males and 339 females, with a mean age o f 55.4 +/- 14.7 years and a time on dialysis of 76.7 +/- 69.6 months. The degree of malnutrition was estimated by scoring four anthropometri c indexes (wt/ht2, triceps skinfold thickness, mid-arm circunference, and mid-arm muscle circumference). The 80.6 % of male patients and the 68.7 % of female patients presented some degree of malnutrition (p < 0,01), and the prevalence of severe malnutrition was 31.0 % and 23.0 % respectively (p < 0,05). Furthermore, mild/severe reductions in mid-a rm muscle circumference predominated in males (20.4 % vs 7.7 %, p < 0, 001), while severe reductions in triceps skinfold thickness were sligh tly more prevalent in females (41.6 % vs 36.0 %). In both sexes; total lymphocyte count and serum creatinine showed a tendency to decrease i n patients with mild and severe malnutrition. There were not differenc es in the concentration of serum total proteins, albumin, pre-albumin, and branched chain essential amino acids. The dose of dialysis measur ed by serum predialysis urea, Kt/V and PCR were similar despite the nu tritional status. The risk factors of malnutrition were as follow: mal e sex, time on hemodialysis and number of complications associated to chronic renal failure. In conclusion, protein-calorie malnutrition is frequent in hemodialysis patients and more prevalent in males. Protein malnutrition predominated in males while caloric malnutrition predomi nated in females. A biochemical parameter that could identify malnutri tion in early stages, was not found.