Valoración del estado nutricional en pacientes en hemodiálisis

Abstract

One of the most important and frequent problems of patients in hemodialysis and a risk factor for mortality, is protein caloric malnutrition without a consensus to evaluate it. The causes of malnutrition are considered to be inflation, hypercatabolism associated with the dialysis procedure, comorbid situations and reduction in protein calorie intake. On the other hand, the association of malnutrition, inflammation and atherosclerosis constitutes a syndrome (MIA) associated with high morbidity and mortality from cardiovascular causes. Different methods have been proposed to assess the nutritional status of the patient among which, in addition to anthropometric and analytical parameters, the Subjective Global Assessment (SGA), the inflation malnourishment score, dual energy x-ray absorptiometry, as well as analysis by spectroscopic bioimpedance (BIS), but none has been accepted individually as a single reference method. However, in recent years, the use of BIS has become widespread in dialysis units. This is an objective, innocuous, cheap and reproducible method to assess body composition and hydration status, and can obtain nutritional parameters that are related to other parameters considered good markers of nutrition.