Valoración e intervenciones nutricionales en pacientes en hemodiálisis

摘要

Introduction: Malnutrition, being a condition with a multifactorial etiology, is very frequent in dialysis patients. Objective: To make a diagnosis of the situation and the evolution of parameters following nutrition intervention. Expected goals after six months: nutritional assessment of 100% of patients; 70% with type A subjective global assessment (SGA); 80% with ≥3.5 g/dL albumin levels, and 70% with 0.8 g/kg/day protein intake (nPNA). Methods: Patients undergoing dialysis for more than 90 days were evaluated during March and April (diagnostic stage) and November and December 2016 (evolution of parameters), recording personal, anthropometric and laboratory data, food history and SGA. The nutritional actions were: interviews to patients and relatives, education through group talks and indication of hyperproteic supplements to patients selected according to appetite, weight loss and albumin. Results: In the diagnostic stage, 35 patients were evaluated; 18 (51%) had BMI 23 and 35; 9 (26%) with nPNA 0.8 g/kg/day. Albumin was ≥3.5 g/dL in 24 patients (69%). Type A SGA in 16 patients(46%); type B in 12 of them (34%) and type C in 7 (20%). Five patients received supplements (14%). In a later stage, 28 patients were evaluated; 11 (39%) with BMI 23 and 35. nPNA; 0.8 g/kg/day in 27 patients (96%). Albumin was ≥3.5 g/dL in 23 patients (82%). Type A SGA in 18 patients (64%); type B in 9 of them (32%) and type C in 1 (4%). 100% of the supplemented subjects achieved the expected goals. Conclusion: Periodic nutritional assessment, interventions and supplementation improve the short-term nutritional goals of the dialysis population.