Inter-relação entre perfil nutricional, risco de sarcopenia e adequacidade de diálise em pacientes renais crônicos dialíticos de Maceió-AL

Abstract

INTRODUCTION: Chronic Kidney Disease (CKD) is an abnormality in the structure and/or function of the kidney present for a period equal to or greater than three months. It is a progressive disease, and in the final stages, hemodialysis is the most prevalent kidney replacement treatment. Many metabolic, nutritional and clinical alterations result from the evolution of the disease, resulting in uremic myopathy, energy-protein malnutrition, sarcopenia, among others. OBJECTIVE: To evaluate the interrelationship between the nutritional profile, the risk of sarcopenia and the adequacy of hemodialysis in chronic kidney failure patients on dialysis. MATERIALS AND METHODS: Cross-sectional observational study of an analytical nature with individuals of both sexes, over 18 years old, diagnosed with CKD on renal replacement therapy for at least 6 months. This study is part of the scope of the research “Interrelationship of the nutritional, inflammatory and cardiovascular profile in chronic renal failure patients on dialysis”, duly approved by the Ethics Council (CAAE 48138121.6.0000.0155, opinion n◦ 5.047.663). For this research, socio-demographic, clinical and anthropometric data (weight, height, waist circumference (WC), calf circumference (LC)) were included, through a standardized protocol by the group and the screening questionnaire for the risk of sarcopenia with inclusion of CP (SARC-Calf). Analyzes were conducted in R Software (Version 4.2.1, R Core Team, 2022). RESULTS: The sample obtained a total n = 149. Adults (n=76) and males (64%) were more prevalent. The WC had an average of 33.5 cm ± 3.6, WHR with mean values of 0.57±0.09, WC with 94cm ±14 and BMI with a general mean of 26.2 kg/m² ± 5.2. SARC-Calf averaged 6.6 ± 5.3 for adults and 5.8±4.2 for elderly and 20% at risk in the overall sample. In Kt/V, mean of 1.64 ± 0.47 in adults and 1.48 ± 0.43 in the elderly. There was a weak negative correlation between Kt/V and CC (-0.27 ([-0.45, -0.07]; Pvalue=0.01) and Kt/V and CP (-0.26 ([-0.45, -0.06]; p<0.01) and weak positive correlation between Kt/V and SARC-Calf (0.21([0.04, 0.37]; P-value = 0.01). CONCLUSION: There is an association between the nutritional profile, risk of sarcopenia and adequacy of dialysis, as coefficients were observed of correlation that demonstrate the trend of lower Kt/V, that is, lower hemodialysis efficiency, for higher CC and CP values.