Nutritional Status of Patients with Chronic Kidney Disease undergoing Hemodialysis
DOI:
https://doi.org/10.52379/mcs.v9.712Keywords:
Hemodialysis, Nutrional status, Body mass index, Chronic kidney disease, anthropometryAbstract
Introduction: Chronic kidney disease (CKD) is a major public health issue, with a global prevalence of nearly 13% and a growing burden in Latin America and Paraguay. In advanced stages, hemodialysis becomes indispensable but may negatively affect nutritional status, leading to both undernutrition and overweight. Nutritional assessment through indicators such as body mass index (BMI) and sociodemographic data is essential to understand these alterations and guide intervention strategies. Objective: To evaluate the nutritional status of patients undergoing hemodialysis in a private center in Asunción, Paraguay, using anthropometric measurements and sociodemographic data. Methodology: Observational, descriptive, cross-sectional study in 120 adult hemodialysis patients. Sociodemographic information and anthropometric measurements (weight, height, BMI) were collected. Descriptive statistics and association tests were applied. Results: The mean age was 57.2 ± 13.2 years, with a male predominance (56.7%). Mean BMI was 27.3 ± 5.3 kg/m². A high prevalence of overweight (40.8%) and obesity (28.4%) was observed, with no cases of undernutrition. No significant differences in BMI were found between sexes or age groups, although variations in weight and height were noted. Conclusion: Hemodialysis patients showed a high prevalence of overweight and obesity, challenging the traditional perception of undernutrition in this population. These findings highlight the need for personalized nutritional interventions that address the complex nutritional profile of CKD patients
Downloads
References
1. Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease - A systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. https://doi.org/10.1371/journal.pone.0158765
2. Gonzalez-Bedat M, Rosa-Diez G, Pecoits-Filho R, Ferreiro A, García-García G, Cusumano A, et al. Burden of disease: prevalence and incidence of ESRD in Latin America. Clin Nephrol. 2015;83(7 Suppl 1):3–6. https://doi.org/10.5414/cnp83s003
3. Segunda encuesta nacional muestra elevada prevalencia de factores de riesgo – Dirección de Enfermedades no Transmisibles. 2024. https://dvent.mspbs.gov.py/segunda-encuesta-nacional-muestra-elevada-prevalencia-de-factores-de-riesgo/
4. Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, et al. Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr. 2013;23(2):77–90. https://doi.org/10.1053/j.jrn.2013.01.001
5. Steiber AL, Kalantar-Zadeh K, Secker D, McCarthy M, Sehgal A, McCann L. Subjective Global Assessment in chronic kidney disease: A review. J Ren Nutr. 2004;14(4):191–200. https://pubmed.ncbi.nlm.nih.gov/15483778/
6. Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2001;38(6):1251–63. https://doi.org/10.1053/ajkd.2001.29222
7. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391–8. https://doi.org/10.1038/sj.ki.5002585
8. Park J, Ahmadi SF, Streja E, Molnar MZ, Flegal KM, Gillen D, et al. Obesity paradox in end-stage kidney disease patients. Prog Cardiovasc Dis. 2014;56(4):415–25. https://doi.org/10.1016/j.pcad.2013.10.005
9. Ortiz A, Covic A, Fliser D, Fouque D, Goldsmith D, Kanbay M, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383(9931):1831–43. https://doi.org/10.1016/s0140-6736(14)60384-6
10. Kalantar-Zadeh K, Rhee CM, Chou J, Ahmadi SF, Park J, Chen JL, et al. The obesity paradox in kidney disease: How to reconcile it with obesity management. Kidney Int Rep. 2017;2(2):271–81. https://doi.org/10.1016/j.ekir.2017.01.009
11. Zoccali C, Torino C, Tripepi G, Mallamaci F. Assessment of obesity in chronic kidney disease: what is the best measure? Curr Opin Nephrol Hypertens. 2012;21(6):641–6. https://doi.org/10.1097/mnh.0b013e328358a02b
12. Ikizler TA, Cano NJ, Franch H, Fouque D, Himmelfarb J, Kalantar-Zadeh K, et al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84(6):1096–107. https://doi.org/10.1038/ki.2013.147
13. Johansen KL, Lee C. Body composition in chronic kidney disease. Curr Opin Nephrol Hypertens. 2015;24(3):268–75. https://doi.org/10.1097/mnh.0000000000000120
14. Sabatino A, Cuppari L, Stenvinkel P, Lindholm B, Avesani CM. Sarcopenia in chronic kidney disease: what have we learned so far? J Nephrol. 2021;34(4):1347–72. https://doi.org/10.1007/s40620-020-00840-y
15. Kalantar-Zadeh K, Streja E, Molnar MZ, Lukowsky LR, Krishnan M, Kovesdy CP, et al. Mortality prediction by surrogates of body composition: an examination of the obesity paradox in hemodialysis patients using composite ranking score analysis. Am J Epidemiol. 2012;175(8):793–803. https://doi.org/10.1093/aje/kwr384
16. Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et al. KDOQI Clinical Practice Guideline for nutrition in CKD: 2020 update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1–107. https://doi.org/10.1053/j.ajkd.2020.05.006
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Igor Ernesto Marcet Franco, Juan Daniel Acosta González, Claudia Patrícia Quintana, Edis Emanuel Ortigoza, Jazmín Barrios, Patricia Ríos Mujica
This work is licensed under a Creative Commons Attribution 4.0 International License.
