Introduction:
Persistent metabolic acidosis (MA) in haemodialysis (HD) patients leads to protein breakdown, insulin resistance and increased cardiovascular mortality. Many patients receive twice-weekly HD; the average Indian diet has poor protein content. However, there is little literature on the prevalence, determinants, and impact of MA in HD patients in India. We studied the association between protein intake and lean body mass (LBM) with the severity of MA in patients on regular HD
Methods:
This single-centre cross-sectional study enrolled patients >18 years on regular HD for at least three months. Normalised protein catabolic rate (nPCR) was measured, and protein intake was estimated using a diet diary. 24-hour urine nitrogen excretion was measured in patients with residual renal function, and the protein catabolic rate calculated from urea nitrogen excretion was added to the nPCR. LBM was estimated using the bioimpedance spectroscopy technique
Results:
In 107 patients, 49.53% received HD twice a week; AV fistula was the vascular access for 96%, and CKDu was the most common CKD aetiology. 94 (87.85%) patients had MA, and 26 (24.29%) had uncorrected acidosis after HD. 82.05% and 62.9% of men and women had low LBM, respectively. Protein intake in our population was 0.45±0.11 g/kg/day by diet diary and 0.73±0.23gm/kg from nPCR. There was no significant association between LBM and protein intake with severity of MA
Conclusions:
Metabolic acidosis was common among HD patients but did not correlate with protein intake and LBM. Dietary protein intake was very low in HD patients
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.