Protein-energy wasting of haemodialysis patients

Aim. To assess the prevalence of protein-energy wasting (PEW) of haemodialysis patients (HD). Materials and methods. A total of 645 patients receiving treatment with programmatic bicarbonate HD for 8.4 +/- 5.3 years, including 345 women and 300 men, the average age was 56.8 +/- 12.8 years. Nutritional status was assessed using the method recommended by the Ministry of Health of the Russian Federation (MHRF) (accounting form No 003/U), as well as 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 filled in patients for 3 days food diaries. Results and discussion. 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 by the method of MHRF was 75.3%, by the method of ISRNM the prevalence of PEW was 51.2%. There were no statistically significant differences between the patient groups depending on age and the presence of PEW according to the MHRF method (chi(2)=7.072; p=0.069). Similar data were obtained for the method of diagnostics PEW ISRNM. Statistically significant differences between groups of patients were obtained depending on the duration of HD and the presence of PEW according to the MHRF method (chi(2)=22.580; r=0.0001). The prevalence of PEW by the MHRF method increases with increasing duration of HD (Rs=0.184; p=0.0001). Similar data were obtained for the method of diagnosis of PEW ISRNM. Conclusion. The prevalence of PEW in haemodialysis patients was 51.2% according to the ISRNM method and 75.3% according to the MHRF method.