Assessment of nutritional status and risk of death in maintenance haemodialysis patients

作者：Donadio Carlo^*; Kanaki Angelica; Donadio Elena; Tognotti Danika

来源：Healthmed, 2010, 4(1): 210-215.

• Outcome of maintenance haemodialysis
• Electrical body impedance
• Malnutrition

Malnutrition is a major determinant of long-term outcome of maintenance haemodialysis (MHD) patients. The aim of this study was to evaluate the efficiency of electrical body impedance measurement (BIA) to indicate malnutrition and to predict clinical outcome of MHD patients.
BIA was performed during a two year-time period in 126 MHD patients. Twenty-two patients died during this time period. Forty-six patients were re-examined at 2 years interval.
The cross sectional analysis of the 126 MHD patients demonstrated a significant positive correlation between serum albumin (ALB) and phase angle (PA), reactance (Xc), body cell mass (BCM). Age and extra-cellular volume % of total body water (ECW%) correlated negatively with ALB. No correlation was found between body mass index (BMI), or sp Kt/V and ALB. The longitudinal study of 46 patients demonstrated no significant variation in ALB and sp Kt/V, a slight, but statistically significant reduction in BMI (p<0.05) and a highly significant reduction in PA, Xc, BCM, while ECW% significantly increased. Significantly lower values of PA, Xc and BCM and significantly higher values of ECW% were found in the 22 patients deceased within 2 years in comparison with still alive patients, while no difference was found for ALB and sp Kt/V values.
BMI seems inadequate to assess nutritional status in MHD. Data derived from BIA (PA, Xc, BCM and ECW%) are significantly correlated with ALB, which is a validated marker of malnutrition in MHD patients. BIA seems even more sensitive than ALB to predict the risk of death in MHD patients.

• 出版日期2010