Premium
Effect of personalized nutritional counseling in maintenance hemodialysis patients
Author(s) -
Garagarza Cristina Antunes,
Valente Ana Tentúgal,
Oliveira Telma Sobral,
Caetano Cristina Guerreiro
Publication year - 2015
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12260
Subject(s) - medicine , hemodialysis , intensive care medicine
Monitoring nutritional parameters is an integral part of hemodialysis ( HD ) patient treatment program. The purpose of this study was to evaluate the impact of the personalized nutritional counseling ( PNC ) on calcium–phosphorus metabolism, potassium, albumin, protein intake, interdialytic weight gain ( IDWG ), body composition parameters and fluid overload in HD patients. This was a multicenter longitudinal intervention study with 6 months of follow‐up and 731 patients on maintenance HD from 34 dialysis units in P ortugal were enrolled. Biochemical and body composition parameters were measured at baseline, 1, 3 and 6 months after the PNC . Patient's mean age was 64.9 (95% confidence interval [ CI ]: 63.8–66.0) years and mean HD time was 59.8 (95% CI : 55.3–64.3) months. Regarding data comparison collected before PNC vs. 6 months after, we obtained, respectively, the following results: patients with normalized protein catabolic rate ( nPCR ) ≥ 1 g/kg/day = 66.5% vs. 73.5% (P = 0.002); potassium > 5.5 mEq/L = 52% vs. 35.8% (P < 0.001); phosphorus between 3.5 and 5.5 mg/dL = 43.2% vs. 52.5% (P < 0.001); calcium/phosphorus ( Ca / P ) ratio ≤ 50 mg/dL = 73.2 % vs. 81.4% (P < 0.001); albumin ≥ 4.0 g/dL = 54.8% vs. 55% (P = 0.808); presence of relative overhydration = 22.4% vs. 25% (P = 0.283); IDWG > 4.5% = 22.3% vs. 18.2% (P = 0.068). PNC resulted in a significant decrease in the prevalence of hyperkalemia, hypophosphatemia and also showed amelioration in Ca / P ratio, nPCR and an increase in P of hyphosphatemic patients. Our study suggests that dietetic intervention contributes to the improvement of important nutritional parameters in patients receiving hemodialysis treatment.