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Nutritional status of haemodialysis patients: Comparison of A ustralian cohorts of A boriginal and E uropean descent
Author(s) -
Todd Alwyn,
Carroll Robert,
Gallagher Meghan,
Meade Anthony
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12165
Subject(s) - medicine , anthropometry , malnutrition , cohort , diabetes mellitus , dialysis , population , physical therapy , endocrinology , environmental health
Aim It is not known whether nutritional status differs between Australian Aboriginal and non Aboriginal haemodialysis subjects. The aim of this study was to investigate the nutritional status of A ustralian A boriginal and non‐ A boriginal haemodialysis subjects at satellite dialysis centres. Method Seventy‐six (25 A boriginal, 51 non‐ A boriginal) prevalent haemodialysis patients were enrolled in a 3‐month cross‐sectional study. Each month anthropometric and biochemical measurements were collected. Nutritional status (diet history, patient‐generated subjective global assessment ( PG‐SGA ), handgrip strength) was assessed by a dietitian. Results PG‐SGA detected mild to moderate malnutrition in 35% of A boriginal patients and 25% of non‐ A boriginal patients. The overall physical rating on the PG‐SGA was significantly higher in A boriginal patients, indicating the presence of a greater deficit in muscle mass in this population. Inter‐dialytic weight gain was significantly greater in A boriginal subjects (median [range] 3.0 [2.1–5.7] vs 2.5 [−0.3–5.0] kg, P < 0.001). Glucose and HbA1c were significantly higher in A boriginal subjects with diabetes than in non‐ A boriginal patients with diabetes (median [range] 9.4 [4.9–23.4] vs 5.7 [3.1–12.9], P = 0.002; 7.0 [5.2–11.0] vs 5.8 [4.6–9.0], P < 0.000; respectively). These findings occurred in the setting of each cohort having adequate dialysis parameters (median K t/ V of >1.6 and median normalized protein catabolic rate 1.5). Difficulties were encountered in obtaining dietary information from A boriginal subjects using the diet history method. Conclusion Subjects had acceptable parameters of dialysis adequacy; however, 35% had evidence of malnutrition. Further research should focus on establishing a knowledge base for the nutritional management for A boriginal dialysis subjects, and the development of a validated individual dietary assessment method for use in this population group.