Acidose metabólica e o estado nutricional nos pacientes em hemodiálise

Abstract

Background: The prevalence of malnutrition in hemodialysis patients is high, being a marker of poor prognosis in chronic kidney disease. Metabolic acidosis is frequent in a dialysis patient, and has been associated with mortality. Objectives: To evaluate metabolic acidosis and nutritional status of hemodialysis patients. Methods: Cross sectional study in patients on hemodialysis in a single center. Information was collected in medical records and evaluation of the presence of metabolic acidosis and nutritional status as measured by anthropometric and biochemical indicators. Results: The sample consisted of 63 patients, male (54%) and 45 to 64 years old (58.7%). The mean dialysis time was 5.49 ± 4.39 years. The mean value of body mass index was 24.95 ± 6.81 kg / m2 and albumin was 3.93 ± 0.31 g / dL. The prevalence of metabolic acidosis was 77.8%. There was a negative linear correlation between bicarbonate and creatinine (p = 0.006) without correlation with anthropometric and albumin indicators. Patients malnourished according to Body Mass Index gained more interdialytic weight (p = 0.006). They were classified as malnourished by body mass index (55.55%), arm circumference index (14.29%) and 49.20% of patients by albumin (<4.0 g / dL). Creatinine levels were higher in patients aged 45 to 64 years (p = 0.032) and in males. No differences were observed by time in hemodialysis in relation to age, interdialytic weight gain, laboratory and anthropometric measures. Conclusion: The prevalence of metabolic acidosis was high, and there was no correlation with nutritional status. Bicarbonate <22mEq / L correlated with higher creatinine values unrelated to nutritional status. Nutritional assessment by body mass index was in agreement with the Brazilian literature, and albumin indicated elevated malnutrition. The dialysis time did not affect the nutritional evaluation parameters.