Assessment of Nutritional Status of Haemodialysis Patients with Protein Energy Wasting Diagnostic Criteria

Abstract

Aim: Protein energy wasting (PEW) is defined by the International Society of Renal Metabolism and Nutrition (ISRNM) as a state of decreased body protein deposits and energy resources. Protein energy wasting is associated with low quality of life and increased mortality in haemodialysis (HD) patients. This study examined nutritional status of haemodialysis patients according to the PEW criteria recommended by the ISRNM. Subjects and Methods: Fifty patients (50.8 ± 10.7 years) including 26 male and 24 female who received regular HD treatment for at least one year were included in the study. The general characteristics of the patients were learned by questionnaire technique. Food consumption including a dialysis day, a non dialysis day and a weekend were collected with “food consumption record” method, and body composition analysis was performed with a Bodystat-Quadscan 4000 instrument. Protein energy wasting was assessed according to ISRNM criteria. The results of blood samples in routine were taken from computer records of the dialysis center. Results: 44% of patients were diagnosed as having PEW because of met three or more categories. Twenty-eight percent of the patients met two categories, while 26% met one category. 2% of the patients did not meet any of four categories. 54.5% of patients diagnosed with PEW had a serum albumin level of less than 3.8 g/dL and 77.3% had a BMI value of less than 23 kg/m² and the difference was statistically significant compared with non- PEW patients (p<0.05). For all patients diagnosed with PEW, the midarm circumference was less than 10% according to 50% percentile. All of the patients have body fat percentage above 10% and total cholesterol level above 100 mg/dL. Conclusion: PEW which is closely related to mortality is frequently seen in haemodialysis patients. Low albumin level, low BMI, reduced muscle mass is significant markers associated with PEW.