Avaliação nutricional de idosos submetidos à hemodiálise no estado do Amapá

Abstract

Chronic Kidney Disease (CKD) is a clinical syndrome that causes gradual irreversible loss of kidney function. CKD and Hemodialysis (HD) determine conditions directly linked to the nutritional status of the patient, and malnutrition is a major mortality factor in HD patients, a fact confirmed among the elderly. Nutritional assessment (NA) is a complete approach to determine the nutritional status of the individual using the medical, social, nutritional history, physical examination, anthropometric measurements and laboratory data. This study aims to assess the nutritional status of elderly patients with chronic kidney disease undergoing hemodialysis in the Nephrology department of the Clinical Hospital Alberto Lima, in the state of Amapá. This is a quantitative, descriptive study on patients over 60 years old, CKD and performing HD for at least 3 months. Nutritional assessment performed by anthropometry and evaluation of nutrient intake by means of the 24 hour recording method and micronutrient biochemical analysis. The socioeconomic status of each participant was analyzed by a structured questionnaire. Nutritional data were compared to hospital data of each patient, as to the number of admissions to hospital and ICU. It was observed that the majority of interviewed were male (64.58%), only studied up to the 4th grade of elementary school (54.17%), income from 1 to 3 minimum wages (47.92%) and have their meals prepared by relatives (77.08%), a fact that reflects less autonomy in self-care, dietary choices and the possibility of adaptation to the treatment. Concerning nutritional data, the study obtained similar results to those found in other studies in Brazil and worldwide. It showed eutrophia in 41.67% of patients, low weight 22.92% and overweight / obesity in 35.42%. Most patients had normal serum albumin index (70.83%), adequacy of VET consumed under 70% when calculated VET (60.42%), lower protein intake than recommended (54.17%), nutrition monitoring (77.8%), equal proportion among patients who claim to join and not to join the proposed diet (37.5%). Most patients had never been admitted to regular care (31.25%) or Intensive Care (66.66%), some made use of 4 or more drugs per day (41.67%) and the most frequent cardiovascular morbidity was in 87.50% of patients. It can be concluded that the high prevalence of overweight / obesity and malnutrition require special attention to these groups of individuals, especially by negatively influence the development of kidney disease and quality of life of patients.