Acidose metabólica e o estado nutricional de pacientes em hemodiálise

• Autor(a) principal: Machado, Renata Silva
• Data de Publicação: 2022
• Outros Autores: Gomes, Isabel Cristina, Faria, Camila Andreata Marçal de, Navarro, Marina Sad, Castro, Bárbara Rodrigues de, Machado, Luiza Ballesteros, Passos, Maria do Carmo Friche, Almeida, Alessandra Maciel
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: International Journal of Nutrology (Online)
• Texto Completo: https://ijn.zotarellifilhoscientificworks.com/index.php/ijn/article/view/166
• topic: metabolic acidosis; nutritional assessment; malnutrition; hemodialysis

Introduction: The prevalence of malnutrition in hemodialysis (HD) is high, being a marker of poor prognosis in chronic kidney disease. Metabolic acidosis is common on dialysis, and has been associated with mortality. Objectives: To evaluate metabolic acidosis and the nutritional status of HD patients. Methods: A cross-sectional study was carried out in a single HD center. Data were collected from medical records, and the presence of metabolic acidosis and the nutritional status of the patients were verified by anthropometric and biochemical indicators. Results: The total sample of 63 patients, 54% male and 46% female, with 58.7% between 45 and 64 years. The mean dialysis time was of 5.4 years. The mean value of the body mass index (BMI) was 24.9kg/m2, and the mean value of albumin was 3.9g/dL. The prevalence of metabolic acidosis was of 77.8%. There was a negative linear correlation between bicarbonate and creatinine, without correlation with anthropometric and albumin indicators. Patients malnourished according to the BMI corresponded to 55.5% of the total sample and gained more interdialytic weight. Out of the total sample, 14.2% of the patients were classified as malnourished by the arm circumference index, and albumin < 4.0 g/dL was observed in 49.2% of the patients. Serum creatinine was higher in male patients aged between 45 and 64 years old. No difference in time on hemodialysis was observed regarding age, interdialytic weight gain, laboratory, and anthropometric measures. Conclusion: The prevalence of metabolic acidosis was high, and there was no correlation with the nutritional status. Bicarbonate < 22 mEq/L was correlated with higher creatinine values, but was unrelated to the nutritional status. The nutritional assessment by BMI was in agreement with the Brazilian literature, and albumin indicated elevated malnutrition.