Back
Chronic kidney disease (CKD) is characterized by the progressive, gradual and irreversible loss of kidney functions, classified by stages according to the glomerular filtration rate. In stage 5 of the classification adopted by the Brazilian Society of Nephrology (SBN), the patient requires renal replacement therapy, including hemodialysis (HD), which is one of the most common forms of therapy used in Brazil. Despite the benefits of HD, this procedure affects the patient's nutritional status. Patients affected by chronic kidney disease suffer from constant malnutrition not only due to low nutrient intake, but also due to the inflammatory state, as pro-inflammatory cytokines can affect appetite and nutrient metabolism, thus causing changes in body composition. Given the above, the objective was to analyze the nutritional status through the muscle area of the arm of HD patients.
This is a Analytical cross-sectional study with a qualitative and quantitative approach approved by the Research Ethics Committee, carried out in a dialysis clinic in the city of Boa Vista capital of the state of Roraima, in the Legal Amazon, Northern region of Brazil with (n= 55) patients on HD for at least 3 months. Nutritional status was assessed by the arm muscle area (AMB), which is an indicator based on measurements of arm circumference (CB) and tricipital skinfold thickness (PCT). With the AMB value found, it was possible to classify the nutritional status as eutrophic, mild malnutrition, moderate malnutrition and severe malnutrition using the 50th percentile according to sex and age.
Fifty-five patients undergoing hemodialysis treatment participated in the study, with an average age of 51.07 ± 14.65, of which 58.18% were male and 41.82% were female. Regarding gender, it is observed that female patients have a lower average age than male patients. While male patients have a higher average CB and AMB, and lower PCT compared to females, results that are already expected (table 1). As for nutritional classification, it is noted that the average BC follows the nutritional status chart. However, the same could not be observed regarding PCT, given that eutrophic patients have a greater representation of female patients, who have higher PCT. While AMB, like CB, has data aligned with nutritional status, therefore, eutrophic patients have higher averages than other classifications. According to the assessment of nutritional status, it was possible to classify it according to sex, as seen in graph 1. We can see a higher prevalence of eutrophy in female and a higher level of severe malnutrition in male patients.
Male patients generally have a worse nutritional status when compared to females, it is believed that this result is related to quality of life characteristics, especially with regard to physical aspects. Therefore, it is suggested that future research includes variables that can improve monitoring and management measures of nutritional status.