Características clínicas, níveis de hemoglobina e risco de sarcopenia de pacientes em tratamento hemodialítico no agreste de Alagoas

Abstract

Introduction: Introduction: Anemia in Chronic Kidney Disease (CKD) results from insufficient production of erythropoietin by the kidney and characteristic uremic metabolic changes. The chronic anemic condition generates a decrease in nutrition and oxygenation of muscle tissue, altering its functionality and contributing to sarcopenia, which can worsen quality of life and increase morbidity and mortality, making early detection essential for initiating interventions. Objectives: To evaluate the clinical characteristics and verify the association between hemoglobin levels and the risk of sarcopenia in patients with chronic kidney disease undergoing hemodialysis in the countryside of Alagoas. Methods: Cross-sectional analytical study with individuals over 18 years of age with CKD undergoing hemodialysis at the Hemodialysis Service of the Santa Rita Regional Hospital (HRSR) in the city of Palmeira dos Índios and at the Hemodialysis and Arterial Hypertension Center Antonieta Barreto do Centro Manoel André Hospital (CHAMA) in the city of Arapiraca. The study was carried out by collecting data from medical records, followed by the application of questionnaires (socioeconomic, demographic, SARC-F and SARC-FP), anthropometric and biochemical evaluation. The data were tabulated in the Excel® 2010 package and processed by IBM SPSS Software (Statistical Package for the Social Sciences) version 26. The Kolmogorov-Smirnov and Pearson Chi-square tests were used. Then, univariate analysis was performed and variables with p<0.20 were subjected to logistic regression. Results: 300 patients were included, elderly (55.6%), adults (50.6%), predominantly female (50.6%), most illiterate or with incomplete primary education, black/brown (52%), followed by whites and indigenous/yellows. The predominant family income was less than one minimum wage and 1 to 2 MW. Most diabetics, diagnosed with anemia. Receiving iron supplementation (60.6%) and were not using Erythropoietin (EPO). The Body Mass Index of eutrophy prevailed, followed by malnutrition and overweight/obesity. However, arm circumference indicates malnutrition, along with calf circumference. Biochemical tests showed that anemia was present in 58.7%, phosphorus levels were 63% adequate and potassium levels were adequate in 49%. Dialysis adequacy, according to KTV, was 79.3% adequate. In the univariate analysis, age, color, hospitalization, iron supplementation, BMI, WC and Hb were submitted to binomial logistic regression. The significant ones stand out: color (p=0.035), iron supplementation (p=0.006) and CB (p=0.008). Conclusion: The associations indicated a greater chance of self-declared indigenous patients on hemodialysis treatment, with hemoglobin levels indicative of anemia and with a nutritional status of malnutrition based on BMI and WC, having a greater chance of being at risk of sarcopenia, evidenced by the SARC FP questionnaire. In addition to the prevalence of conditions such as DM and hypertension, DM stands out. The socioeconomic factor is of great relevance when analyzing the data from the present study, indicating the need for appropriate strategies and public policies before the advancement of comorbidities, leading to a smaller number of patients requiring renal replacement therapies. Taking into account that this was the first study carried out with people with CKD in HD in rural Alagoas, the need for more local studies is identified.