The prevalence of protein-energy wasting in haemodialysis patients

Abstract

The aim of the study: to assess the prevalence of protein-energy wasting (PEW) in haemodialysis patients (HD). Patients and methods: 645 patients receiving treatment with program bicarbonate HD for 8.4±5.3 years, including 345 women and 300 men, the average age was 56.8±12.8 years were examined. Nutritional status was assessed using the method recommended by the Ministry of Health of the Russian Federation (MHRF) (accounting form № 003/U), and the method proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). The nature of the change in appetite was determined by the Appetite and diet assessment tool (ADAT) and KDQOL-SF (version 1.3). Evaluation of the adequacy of the diet was performed using food diaries filled in by patients for 3 days. Results: a decrease in appetite was recorded in no more than 5% of patients, while these changes were of a persistent, lasting nature. Inadequate intake of essential nutrients, taking into account the recommendations of the ERBP, was found in 9.7% of patients, while inadequate intake of protein was noted. The prevalence of PEW estimated by the MHRF method was 75.3%, and 51.2% for the ISRNM method. No significant difference was found between the patient divided by groups depending on the patient age and the presence of PEW according to the MHRF method (χ2=7.072, p=0.069). Similar data were obtained for the ISRNM method of PEW diagnostics. Statistically significant differences were found between groups of patients with different duration of HD and the presence of PEW accessed by the MHRF method (χ2=22.580, p=0.0001). The prevalence of PEW accessed by the MHRF method increased with the HD duration (Rs=0.184, p=0.0001). Similar data were obtained for the ISRNM method. Conclusion: the prevalence of PEW in haemodialysis patients varies from 51.2 to 75.3%, depending on the method of diagnosis of PEW.