Open AccessIntensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients
Author(s) -
Alessio Molfino,
Alessandro Laviano,
Maria Grazia Chiappini,
Thomas Amman,
Filippo Rossi Fanelli
Publication year - 2012
Publication title -
kidney research and clinical practice
Language(s) - English
Resource type - Journals
eISSN - 2211-9140
pISSN - 2211-9132
DOI - 10.1016/j.krcp.2012.04.487
Subject(s) - medicine , hypophagia , wasting , malnutrition , anorexia , anthropometry , anorexia nervosa , hemodialysis , body mass index , nigerians , eating disorders , physical therapy , body weight , psychiatry , political science , law
Protein-energy wasting is frequently found in haemodialysis (HD) patients. Anorexia and hypophagia contribute to malnutrition, increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether correction of hypophagia influences morbidity and mortality in anorexic HD patients. Thirty-four HD patients were enrolled in a 2-year follow-up programme including regular nutritional assessment. Patients not meeting nutritional requirements during the follow-up, received nutritional counselling, consisting of advice, individually tailored diet and, in case of failure of dietary intervention, artificial nutrition. Biochemical, anthropometric, body composition parameters, morbidity and mortality were recorded in all patients at 12 and 24 months.At baseline, 14 patients (41%) were anorexic, and 20 patients (59%) non-anorexic. Anorexic patients were hypophagic and presented with reduced fat-free mass. After 12 and 24 months, cholesterol, albumin, lymphocyte count and BMI did not differ among groups, while FFM (%) in supplemented anorexic patients significantly improved, being not different any more vs non-anorexic (65.8±4.4 vs 65.4±8.9, respectively; p=n.s.; 65.8±4.4 vs 66.7±10.78, respectively; p=n.s.). Morbidity and mortality were not different among the two groups.In conclusion, in HD patients, nutritional counselling and nutritional support positively affect nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to non-anorexic