Food Intake and Nutritional Status in Stable Hemodialysis Patients

This is a cross-sectional, multicenter, controlled study aiming to evaluate changes of actual dietary nutrient intake in 94 stable hemodialysis patients in respect to 52 normal subjects and guideline recommendations, and to assess the prevalence of signs of malnutrition. Energy and nutrients intake assessment was obtained by a three-day period food recall. Anthropometric and biochemical parameters of nutrition, bioelectric impedance vector analysis, and subjective global assessment (SGA) have been performed to assess nutritional status. SGA-B was scored in 5% of the patients. Body mass index < 20 Kg/m(2), serum albumin < 35 g/L, nPNA < 1.0 g/Kg, and phase angle < 4.0 degrees were detected in 16.3%, 16%, 23%, and 8.0 % of patients, respectively. HD patients showed a lower energy and protein intake in respect to controls, but no difference occurred when normalized per ideal body weight (29.3 +/- 8.4 vs. 29.5 +/- 8.4 Kcal/Kg i.b.w./d and 1.08 +/- 0.35 vs. 1.12 +/- 0.32 Kcal/Kg i.b.w./d, respectively). Age was the only parameter that inversely correlates with energy (r = -0.35, p < 0.001) and protein intake (r = -0.34, p < 0.001). This study shows that in stable dialysis patients, abnormalities of nutritional parameters are less prevalent than expected by analysis of dietary food intake. Age is the best predictor of energy and protein intake in the dialysis patients who ate less than normal people, but no difference emerged when energy and protein intakes were normalized for body weight. These results recall the attention for individual dietetic counseling in HD patients, and also for a critical re-evaluation of their dietary protein and energy requirements.