Nutritional risk and its association with anthropometric, clinical and biochemical parameters in patients with chronic kidney disease on hemodialysis
DOI:
https://doi.org/10.52521/nutrivisa.v12i1.15615Palabras clave:
nutritional assessment, nutritional risk, chronic kidney disease, hemodialysisResumen
To investigate the association between higher nutritional risk and sociodemographic, anthropometric, clinical and biochemical parameters in hemodialysis patients. This is a cross-sectional study of adult and elderly patients with chronic kidney disease undergoing hemodialysis in Western Bahia. For the data collection, the modified subjective global assessment was used, anthropometric measurements were taken and clinical and biochemical data were obtained from the patients' medical records. Multiple linear regression analysis was used to assess the relationship between the highest score on the subjective global assessment and anthropometric, clinical and biochemical parameters. A total of 98 patients were assessed, 64.3% male and 59.2% aged between 35 and 59 years. The mean modified subjective global assessment score was 11,3±3,8. The prevalence of nutritional risk and malnutrition together was 73.3%. A positive association was found between higher nutritional risk and female sex (p=0.014), longer duration of hemodialysis treatment (p=0.010), higher serum potassium concentration (p=0.009) and higher pre-dialysis serum urea concentration (p=0.043). Higher nutritional risk is positively associated with female sex, longer hemodialysis treatment time, hyperpotassemia, and hyperphosphatemia in patients with chronic kidney disease.
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ALVARENGA, L.A.; ANDRADE, B.D.; MOREIRA, M.A.; NASCIMENTO, R.P.; MACEDO, I.D.; AGUIAR, A.S. Análise do perfil nutricional de pacientes renais crônicos em hemodiálise em relação ao tempo de tratamento. J Bras Nefrol. v. 39, n. 3, p. 283-86, 2017. Disponível em: https://doi.org/10.5935/0101-2800.20170052
ANDRADE, I.S.; CUNHA, C.M.; BRITO, B.P.; FRANÇA, F.C.O.; OLIVEIRA, L.P.M. Malnutrition and cardiovascular risk in haemodialysis patients with chronic kidney disease. Rev. Nutr. v. 32, e190050, 2019. Disponível em: https://doi.org/10.1590/1678-9865201932e190050
ASSOCIAÇÃO BRASILEIRA DE EMPRESAS DE PESQUISA. Critério de Classificação econômica Brasil. São Paulo: ABEP; 2016 [Accessed 2022 Nov 14]. Available at: http://www.abep.org/criterio-brasil.
ASSOCIAÇÃO BRASILEIRA PARA O ESTUDO DA OBESIDADE E DA SÍNDROME METABÓLICA - ABESO. Diretrizes brasileiras de obesidade 2016. 4th ed. São Paulo: ABESO; p. 17, 2016.
AVESANI, C.M.; SABATINO, A.; GUERRA, A.; RODRIGUES, J.; CARRERO, J.J.; ROSSI, G.M.; GARIBOTTO, G.; STENVINKEL, P.; FIACCADORI, E.; LINDHOLM, B.A. A Comparative Analysis of Nutritional Assessment Using Global Leadership Initiative on Malnutrition Versus Subjective Global Assessment and Malnutrition Inflammation Score in Maintenance Hemodialysis Patients. J Ren Nutr. v. 32, n. 4, p. 476-482, 2022. Disponível em: https://doi.org/10.1053/j.jrn.2021.06.008
AZIZ, G.; EBRAHIM, Z.; ESAU, N.; BAZEZEW, M.M. Assessment Criteria to Diagnose Malnutrition (Undernutrition and Overnutrition) in Hemodialysis Patients. J Ren Nutr. v. 22, n. S1051-2276(24)00194-8, 2024. Disponível em: https://doi.org/10.1053/j.jrn.2024.08.003
BALAFA, O.; FERNANDEZ-FERNANDEZ, B.; ORTIZ, A.; DOUNOUSI, E.; EKART, R.; FERRO, C.J.; MARK, P.B.; VALDIVIELSO, J.M.; DEL VECCHIO, L.; MALLAMACI, F. Sex disparities in mortality and cardiovascular outcomes in chronic kidney disease. Clin Kidney J., v. 21, n. 3, p. sfae044, 2024. Disponível em: https://doi.org/10.1093/ckj/sfae044
BEN-NOUN, L.; LAOR, A. Relationship of neck circumference to cardiovascular risk factors. Obes Res. v. 11, n. 2. p. 226-231, 2006. Disponível em: https://doi.org/10.1038/oby.2003.3
BOUSQUET-SANTOS, K.; COSTA, L.D.G.D.; ANDRADE, J.M.L. Estado nutricional de portadores de doença renal crônica em hemodiálise no Sistema Único de Saúde [Nutritional status of individuals with chronic renal failure in hemodialysis in the Unified Health System]. Cien Saude Colet. v. 24, n. 3, p. 1189-1199, 2019. Disponível em: https://doi.org/10.1590/1413-81232018243
CARRERO, J.J.; THOMAS, F.; NAGY, K.; AROGUNDADE, F.; AVESANI, C.M.; CHAN, M.; CHMIELEWSKI, M.; CORDEIRO, A.C.; ESPINOSA-CUEVAS, A.; FIACCADORI, E.; GUEBRE-EGZIABHER, F.; HAND, R.K.; HUNG, A.M.; IKIZLER, T.A.; JOHANSSON, L.R.; KALANTAR-ZADEH, K.; KARUPAIAH, T.; LINDHOLM, B.; MARCKMANN, P.; MAFRA, D.; PAREKH, R.S.; PARK, J.; RUSSO, S.; SAXENA, A.; SEZER, S.; TETA, D.; TER WEE, P.M.; VERSEPUT, C.; WANG, A.Y.M.; XU, H.; LU, Y.; MOLNAR, M.Z.; KOVESDY, C.P. Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism. J Ren Nutr. v. 28, n. 6, p. 380-392, 2018. Disponível em: https://doi.org/10.1053/j.jrn.2018.08.006
CEDERHOLM, T.; BARAZZONI, R.; AUSTIN, P.; BALLMER, P.; BIOLO, G.; BISCHOFF, S.C.; COMPHER, C.; CORREIA, I.; HIGASHIGUCHI, T.; HOLST, M.; JENSEN, G.L.; MALONE, A.; MUSCARITOLI, M.; NYULASI, I.; PIRLICH, M.; ROTHENBERG, E.; SCHINDLER, K.; SCHNEIDER, S.M.; DE VAN DER SCHUEREN, M.A.; SIEBER, C.; VALENTINI, L.; YU, J.C.; VAN GOSSUM, A.; SINGER, P. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. v. 36, n. 1, p. 49-64, 2017. Disponível em: https://doi.org/10.1016/j.clnu.2016.09.004
CEDERHOLM, T.; ROTHENBERG, E.; BARAZZONI, R. Editorial: A Clinically Relevant Diagnosis Code for "Malnutrition in Adults" Is Needed in ICD-11. J Nutr Health Aging. v. 26, n. 4, p. 314-315, 2022. Disponível em: https://doi.org/10.1007/s12603-022-1774-z
CHEN, J.; PENG, H.; YUAN, Z.; ZHANG, K.; XIAO, L.; HUANG, J.; WANG, J.; HUANG, H. Combination with anthropometric measurements and MQSGA to assess nutritional status in Chinese hemodialysis population. Int J Med Sci. v. 13, n. 10, p. 974-980, 2013. Disponível em: https://doi.org/10.7150/ijms.5811
CHUNG, S.; KOH, E.S.; SHIN, S.J.; PARK, C.W. Malnutrition in patients with chronic kidney disease. Open J Intern Med. v. 2, p. 89-99, 2012. Disponível em: https://doi.org/10.4236/ojim.2012.22018
DAHL, H.; WARZ, S.I.; WELLAND, N.L.; ARNESEN, I.; MARTI, H.P.; DIERKES, J. Factors associated with nutritional risk in patients receiving haemodialysis assessed by Nutritional Risk Screening 2002 (NRS2002). Journal Of Renal Care, [S.L.], v. 48, n. 2, p. 112-118, 11 maio 2021. Disponível em: https://doi.org/10.1111/jorc.12374
FERRELL, C.; BYHAM-GRAY, L.; SAMAVAT, H.; HAMDAN, M. Potential Determinants of Subjective Global Assessment Among Patients on Maintenance Hemodialysis. J Ren Nutr. v. 15, p. S1051-2276(24)00064-5, 2024. Disponível em: https://doi.org/10.1053/j.jrn.2024.04.003
IKIZLER, T.A.; BURROWES, J.D.; BYHAM-GRAY, L.D.; CAMPBELL, K.L.; CARRERO, J.J.; CHAN, W.; Fouque, D.; Friedman, A.N.; Ghaddar, S.; Goldstein-Fuchs, D.J.; Kaysen, G.A.; Kopple, J.D.; Teta, D.; Yee-Moon Wang, A.; Cuppari, L. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. v. 76, n. 3 Suppl 1, p. S1-S107, 2021. Erratum in: Am J Kidney Dis. V. 77, n. 2, p. 308, 2021. Disponível em: https://doi.org/10.1053/j.ajkd.2020.11.004
IOREMBER, F.M. Malnutrition in Chronic Kidney Disease. Front Pediatr. n. 20, n. 6, p. 161, 2018. Disponível em: https://doi.org/10.3389/fped.2018.00161
KOEHNLEIN, E.A.; YAMADA, N.A.; GIANNASI, A.C.B. Avaliação do estudo nutricional de pacientes em hemodiálise. Acta Sci Health Sci. v. 30; p. 65-71, 2008. Disponível em: https://doi.org/10.4025/actascihealthsci.v30i1.4397
KOVESDY, C.P.; MATSUSHITA, K.; SANG, Y.; BRUNSKILL, N.J.; CARRERO, J.J.; CHODICK, G.; HASEGAWA, T.; HEERSPINK, H.L.; HIRAYAMA, A.; LANDMAN, G.W.D.; LEVIN, A.; NITSCH, D.; WHEELER, D.C.; CORESH, J.; HALLAN, S.I.; SHALEV, V.; GRAMS, M.E.; CKD PROGNOSIS CONSORTIUM. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. Eur Heart J. v. 1, n. 39, p. 1535-1542, 2018. Disponível em: https://doi.org/10.1093/eurheartj/ehy100
LEMOS, K.C.R.; GARCIA, A.N.M.; SANTOS, T.O.C.D.; VIEIRA, N.F.L.; SANTOS, A.C.O.D. Association between malnutrition-inflammation score (MIS) and quality of life in elderly hemodyalisis patients. J Bras Nefrol. v. 46, n. 4, p. e20230171, 2024. Disponível em: https://doi.org/10.1590/2175-8239-JBN-2023-0171en
PENG, H.; AOIEONG, C.; TOU, T.; TSAI, T.; WU, J. Clinical assessment of nutritional status using the modified quantified subjective global assessment and anthropometric and biochemical parameters in patients undergoing hemodialysis in Macao. J Int Med Res. v. 49, n. 9, p. 3000605211045517, 2021. Disponível em: https://doi.org/10.1177/03000605211045517
PICARD, K.; BARRETO SILVA, M.I.; MAGER, D.; RICHARD. C. Dietary Potassium Intake and Risk of Chronic Kidney Disease Progression in Predialysis Patients with Chronic Kidney Disease: A Systematic Review. Adv Nutr. v. 11, n. 4, p. 1002-1015, 2020. Erratum in: Adv Nutr. v. 14, n. 6, p. 1657, 2023. Disponível em: https://doi.org/10.1016/j.advnut.2023.09.014
PUPIM, L.B.; IKIZLER, T.A. Uremic malnutrition: new insights into an old problem. Semin Dial. v. 16, n. 3, p. 224-232., 2003. Disponível em: https://doi.org/10.1046/j.1525-139x.2003.16046.x
RODRÍGUEZ-CHÁVEZ, L.A.; RAMÍREZ-PACHAMANGO, S.; RODRÍGUEZ-MENDOZA, C.R.E. Frequency of malnutrition in adult patients with stage V chronic kidney disease on hemodialysis. Rev Peru Med Exp Salud Publica. v. 31, n. 41, p. 399-404, 2025. Disponível em: https://doi.org/10.17843/rpmesp.2024.414.13638
SAHATHEVAN, S.; KHOR, B.H.; NG, H.M.; GAFOR, A.H.A.; MAT DAUD Z.A.; MAFRA, D.; KARUPAIAH, T. Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review. Nutrients. V. 12, v. 10, p. 3147, 2020. Disponível em: https://doi.org/10.3390/nu12103147
SILVA, A.M.; SOUTO, T.C.; FONSECA, F.; MORAIS, C.N.; SOUZA, B.S. Estado nutricional de pacientes renais crônicos submetidos a tratamento hemodiálitico em um hospital de referência de Pernambuco. Nutricíon Clinica, v.37, n. 3, p 58-65, 2017.
STEIBER, A.; LEON, J.B.; SECKER, D.; MCCARTHY, M.; MCCANN, L.; SERRA, M.; Sehgal, A.R.; Kalantar-Zadeh, K. Multicenter study of the validity and reliability of subjective global assessment in the hemodialysis population. J Ren Nutr. v. 17, n. 5, p. 336-342, 2007. Disponível em: https://doi.org/10.1053/j.jrn.2007.05.004
STEIBER, A.L.; KALANTAR-ZADEH, K.; SECKER, D.; MCCARTHY, M.; SEHGAL, A.; MCCANN, L. Subjective Global Assessment in chronic kidney disease: a review. J Ren Nutr. v. 14, n. 4, p. 191-200, 2004.
STUQUI, M.; BECCARIA, L.M.; ALBERTINI, S.M.; GODOY, M.F. Ângulo de fase como potencial marcador do estado nutricional de pacientes em terapia intensiva. Cogitare Enfermagem, [S.L.], n. 27, p. 1-11, 18 nov. 2022. Disponível em: https://doi.org/10.5380/ce.v27i0.81947.
TSAI, M.T.; TSENG, W.C.; OU, S.M.; LEE, K.H.; YANG, C.Y.; TARNG, D.C. Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients. Nutrients. v. 30, n. 6, p. 1870, 2021. Disponível em: https://doi.org/10.3390/nu13061870
VEGINE, P.M.; PACKNESS, A.C.; SIMAS, M.R.; TORRES, G.; BARRETO, M.I.; AVESANI, C.M. Avaliação de métodos para identificar desnutrição energético proteica de pacientes em hemodiálise. J Bras Nefrol. v. 33, n. 1, p. 55-61, 2011. Disponível em: https://doi.org/10.1590/S0101-28002011000100008
WYLD, M.L.R.; MATA, N.L.; VIECELLI, A.; SWAMINATHAN, R.; O'SULLIVAN, K.M.; O'LONE, E.; ROWLANDSON, M.; FRANCIS, A.; WYBURN, K.; WEBSTER, A.C. Sex-Based Differences in Risk Factors and Complications of Chronic Kidney Disease. Semin Nephrol. v. 42, n. 2, p. 153-169, 2022. Disponível em: https://doi.org/10.1016/j.semnephrol.2022.04.006
XI, W.Z.; WU, C.; LIANG, Y.L.; WANG, L.L.; CAO, Y.H. Analysis of malnutrition factors for inpatients with chronic kidney disease. Front Nutr. v. 6, n. 9, p. 1002498, 2023. Disponível em: https://doi.org/10.3389/fnut.2022.1002498
YAMADA, S.; INABA, M. Potassium Metabolism and Management in Patients with CKD. Nutrients. v. 13, n. 6, p. 1751, 2021. Disponível em: https://doi.org/10.3390/nu13061751
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Derechos de autor 2025 Danielle Cristina Guimarães da Silva, Lara Maria Novaes de Souza, Danielle Mendes Mariano, Hemilly Lorrane Ribeiro Cordeiro, Fabrícia Geralda Ferreira

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.







