Rajaa Essadik1, Rajaa Msaad1, Halima Lebrazi1, Hassan Taki1, El Hassane Tahri2, Anass Kettani1, Ghizlane Madkouri3, Benyounes Ramdani3, Rachid Saïle4. 1. Laboratory of biology and health, URAC 34, Hassan II university-Casablanca, faculty of sciences Ben M'Sik, avenue Cdt Driss El Harti, BP 7955, Sidi Othmane, Casablanca, Morocco. 2. Laboratory of molecular genetics and pathophysiology, Hassan II university-Casablanca, faculty of sciences Ben M'sik, avenue Cdt Driss El Harti, BP 7955, Sidi Othmane, Casablanca, Morocco. 3. Department of nephrology-transplantation and hemodialysis, university hospital center Ibn Rochd, Casablanca, Morocco. 4. Laboratory of biology and health, URAC 34, Hassan II university-Casablanca, faculty of sciences Ben M'Sik, avenue Cdt Driss El Harti, BP 7955, Sidi Othmane, Casablanca, Morocco. Electronic address: sailerachid@yahoo.fr.
Abstract
INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in haemodialysis (HD) patients. However, there is no consensus for its assessment. The present study aimed to assess the nutritional status of patients on chronic HD by use of different nutritional assessment parameters, and at verifying which can identify the greatest number of HD patients with PEW. Also, to investigate predictors of nutritional status in a haemodialysis center in Morocco. PATIENTS AND METHODS: This is a cross-sectional analysis performed on 126 patients aged 44.82±14.01 years, undergoing maintenance HD in the Department of nephrology of the university hospital centre of Casablanca, Morocco. Energy and nutrients intake assessment was obtained by a three-day period food recall. Biochemical parameters, bioelectric impedance analysis, and subjective global assessment (SGA), have been performed to assess nutritional status. RESULTS: According to SGA the prevalence of PEW was 74.62%. However, when using the ISRMN malnutrition criteria only 36.50% of the patients were diagnosed with PEW. Pearson correlation showed a negative association between the degree of malnutrition evaluated by SGA and serum prealbumin (r=-0.54; P=0.0001), serum albumin (r=-0.50; P=0.001), energy (r=-0.34; P=0.002), protein intake (r=-0.41; P=0.0001), and a significant positive correlation with CRP (r=0.65; P=0.0001) was determined, but not with anthropometric measurements nor lipids profile. The areas under the receiver operating characteristic curve were 0.841 (95% CI: 0.751-0.932) for serum prealbumin, and 0.737 (95% CI: 0.634-0.840) for serum albumin. CONCLUSION: Our results showed a high prevalence of PEW among Haemodialysis patients. Also, our findings suggest that SGA, serum albumin and prealbumin may be relative appropriate and practical markers for assessing nutritional status in HD patients.
INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in haemodialysis (HD) patients. However, there is no consensus for its assessment. The present study aimed to assess the nutritional status of patients on chronic HD by use of different nutritional assessment parameters, and at verifying which can identify the greatest number of HDpatients with PEW. Also, to investigate predictors of nutritional status in a haemodialysis center in Morocco. PATIENTS AND METHODS: This is a cross-sectional analysis performed on 126 patients aged 44.82±14.01 years, undergoing maintenance HD in the Department of nephrology of the university hospital centre of Casablanca, Morocco. Energy and nutrients intake assessment was obtained by a three-day period food recall. Biochemical parameters, bioelectric impedance analysis, and subjective global assessment (SGA), have been performed to assess nutritional status. RESULTS: According to SGA the prevalence of PEW was 74.62%. However, when using the ISRMN malnutrition criteria only 36.50% of the patients were diagnosed with PEW. Pearson correlation showed a negative association between the degree of malnutrition evaluated by SGA and serum prealbumin (r=-0.54; P=0.0001), serum albumin (r=-0.50; P=0.001), energy (r=-0.34; P=0.002), protein intake (r=-0.41; P=0.0001), and a significant positive correlation with CRP (r=0.65; P=0.0001) was determined, but not with anthropometric measurements nor lipids profile. The areas under the receiver operating characteristic curve were 0.841 (95% CI: 0.751-0.932) for serum prealbumin, and 0.737 (95% CI: 0.634-0.840) for serum albumin. CONCLUSION: Our results showed a high prevalence of PEW among Haemodialysis patients. Also, our findings suggest that SGA, serum albumin and prealbumin may be relative appropriate and practical markers for assessing nutritional status in HDpatients.