MO610NUTRITIONAL PARAMETERS OF PATIENTS WITH END-STAGE RENAL DISEASE IN THE GENERAL UNIVERSITY HOSPITAL AREA
Authors: Mañas Christian , Palacios Castillo Angel , Bea Granell Sergio , Galan Serrano Antonio 
Published: May 2021

Background

Malnutrition is one of the problems that patients can develop during the later stages of kidney disease. These problems are derived from uraemia and acidosis that can present due to the decrease in glomerular filtration and added to an accumulation of urine levels. During the months of January 2019 and May 2020 were collected information of 564 patients about age, weight, height, BWI, glomerular filtration rate, use of oral nutrition supplements and albumin, protein, phosphorous and potassium biochemical levels. All of patients were had a GFR below 45 mL/min/1,73m2 and any of them have been started a renal replacement therapy when the data was collected. A descriptive and frequency analysis has been carried out with all the parameters obtained. The T of Student for a related sample test was used due to the normality of the data and the participants condition of intervention – control.

Results

The results indicate that the mean values for ESRD patients in our area are: age (75,3±12,5 years old), weight (74,7±15,6 kg), height (1,6±0,1 m), IMC (28,8±5,4 kg/m2), glomerular filtration rate (19,9±9,1 mL/min/1,73m2), albumin (3,7±0.5 g/dL), protein (6,8±0,7 g/dL), phosphorous (4,2±1,1 mg/dL) and potassium (4,6±0,5 mEq/L). 41 patients (7,3%) used oral nutrition supplements. We found statistical significance between the stages 4 and 5 of kidney disease and albumin (p-value 0.03 and 0.04) and potassium (p-value 0.04 and 0.04) levels. Only at stage 4 we found statistical significance between the levels of protein (p-value 0.04) and phosphorous (p-value 0.04). Also were found increased levels of albumin (3,73 vs 3,7 mg/dL), proteins (6,87 vs 6,8 mg/dL), phosphorous (4,4 vs 4,3 mg/dL) and potassium (4,8 vs 4,6 mg/dL) in the group who use oral nutrition supplements, however, we did not reach statistical significance between groups. About correlations, we found that the albumin levels have a statistical significance with age, protein, phosphorous and potassium levels, but not with BWI.

Conclusion

In the General University Hospital area, the patients in ESRD have a high BWI, which can impair the renal disease. Also, we found that BWI decrease in end stages of ESRD worsening the nutritional status before start the renal replacement therapy. About albumin, the worst levels were found at stage 4 of the kidney disease and older patients have more risk of present low albumin levels. The mean values of albumin show that most of our patients meet one of three conditions to diagnose PEW. The protein level was lower at the 5 stage of the disease, and as the albumin, the older patients show lower values of this parameter. Concerning phosphorous and potassium the patients at the end stage of renal disease present higher values of both of them due possibly to the impaired renal function. About the use of nutritional supplements, a low percentage of patients used this as nutritional therapy, but mean levels of biochemical parameters such as albumin, protein, phosphorous and potassium were higher than the patients who did not use them. However, we did not find statistical significance between the use of ONS and better status of biochemical parameters.

We can say that older patients in end stage of renal disease have a higher risk of malnutrition in comparison with young patients due to a decrease in BWI, albumin and protein levels. To conclude, the nutritional treatment to these patients should consist, on the one hand, the decrease of the BWI to prevent a quickly loss of renal function and, on the other hand, prevent the malnutrition, especially in the older patients with lower BWI.