Daily nutrient intake in hemodialysis

摘要: BACKGROUND Although there is a higher nutrient requirement, food intake in haemodialysis patients often inadequate. Protein nitrogen appearance (PNA) indirectly estimates the mean protein during short interdialysis period, but it does not measure daily intake, which generally unknown. We carried out longitudinal study aimed at estimating and its relationship with nutritional status of patients. METHODS selected 28 adequate no evidence risk-factor for malnutrition. Patients were treated biocompatible membranes, low-flux high bicarbonate dialysis, Kt/V > 1.2, PNA 1.1 g/kg/day erythropoietin. measured every four months PNA, calorie (DPI, DCI) as well weight gain (WG) an entire week one-year. The was assessed by biochemical BIA markers. RESULTS Twenty seven subjects (8 F, 19 M; age 57.1 +- 2.7 yeas; dialysis 105 13 months) completed trial. interdialytic did change both long- short-interdialysis periods, resulting "normal" range (> g/kg/day); however, levels significantly reduced on third day long interval. Eight showed time-averaged values DPI DCI lower than 0.8 25 Kcal/kg/day, respectively, (LOW group), that associated similar changes WG. Such highly normal value (1.23 0.05 vs 1.30 0.06 CON, NS) when period (S), just clinical practice; contrast, found to be (1.07 0.08 1.37 p < S, 0.05). During study, body progressively decreased from 68.0 5.5 65.8 5.9 kg (p 0.05) LOW group, due decrease lean mass, suggested reduction serum creatinine (9.2 8.1 0.7 mg/dL, 0.05), generation (835 155 723 106 mg/die, albumin (3.96 0.07 3.66 g/dL, Moreover, reactance phase angle declined group (from 54 4 44 3 ohms, 0.3 4.5 degrees, 0.05, respectively). At end compared CON group. CONCLUSIONS In stable, well-nourished patients, absence known risk factors malnutrition, variable reduce measurement done practice, enable discovery such abnormal eating behaviour; low contrary, can evidenced either or gain, also inferred period. Finally, persistent below threshold proteins Kcal/kg/day one week, capable inducing wasting moderate impairment status.