[Visceral protein status and hyperlipoproteinemia in patients on hemodialysis]

Long-term therapy and inadequate diet regimens in terminal phase patients with renal insufficiency lead to loss of body weight which causes changes in anthropometric indexes. The occurrence of hypoalbuminemia in chronic hemodialysis patients without nephrotic syndrome, is a clear sign of malnutrition. The aim of this study was to establish the visceral protein status in these patients as well as to find if there is a difference in this status in regard to hyperlipemic and normolipemic patients. 45 chronic dialysis patients were examined: 26 males with a mean age of 52.4 years and 19 females with a mean age of 51.3 years. They were divided into two groups: the first group of 22 hyperlipemic patients and the second group of 23 normolipemic patients. The control group consisted of 18 healthy subjects (9 females with a mean age of 58.3 years and 9 males with a mean age of 55.7 years). In regard to lipid fractions we determined the total cholesterol, HDL (high density lipoprotein), LDL (low density lipoprotein) cholesterol and triglycerides. The following anthropometric indexes have been used: BMI (body mass index) and muscle mass index (triceps). Albuminemia was performed in all subjects as an indicator of undernutrition. There was a significant difference in albumin level in hyperlipemic and healthy subjects (p = 0.0001), as well as normolipemic and healthy subjects (p = 0.0001), whereas no significant difference was established between hyperlipemic and normolipemic subjects. Values for triceps as a muscle mass index significantly differed in the group of normolipemic subjects (p = 0.03). Body mass index did not significantly differ among groups. In the group of normolipemic subjects BMI was significantly in correlation with values for triceps (p = 0.001). Significant correlation between albumin level and anthropometric indexes was not established. Gathered results indicate that in the group of normolipemic hemodialysis patients malnutrition can be dangerous.