Assessment of nutritional status in haemodialysis patients

Malnutrition is a common problem and a risk factor of mortality in haemodialysis patients. However, there is no consensus for its assessment.

To assess the relationship between nutritional status, measured by bioimpedance spectrometry (BIS), and laboratory markers of nutritional status, as well as nutritional evolution and its changes after 1 year.

We performed an observational prospective study on 124 haemodialysis patients (aged 61.2 ±[15.8] years, 62.9% were males, 33.1% were diabetic. Laboratory markers of nutritional status and BIS were implemented at baseline and after one year.

At baseline, lean mass index (LMI) (13.3 [3.6] Kg/m2) was inversely correlated with age (P=.006), and directly with male gender (P=.01). At baseline, the fat mass index (FMI) (mean 11.2 & 6.1kg/m2) correlates directly with the body mass index (P<.001) and the female gender (P=.004). We found no association with comorbidity or inflammatory markers. We did not observe any correlation between lean mass or fat mass modifications and nutritional marker modifications. Patients with LMI gain (>0kg/m2) have lower baseline serum albumin (P=.017), lower baseline LMI (P<.001) and higher baseline FMI (P=.027). Patients with FMI loss (<0kg/m2) have lower systolic blood pressure (P=.04).

Assessment of nutritional status through laboratory parameters does not have a good correlation with body composition parameters or with their modifications.