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Haemodialysis patients with diabetes eat less than those without: A plea for a permissive diet
Author(s) -
Bataille Stanislas,
Landrier JeanFrançois,
Astier Julien,
Cado Sylvie,
Sallette Jérôme,
Giaime Philippe,
Sampol Jérôme,
Sichez Hélène,
Ollier Jacques,
Gugliotta Jean,
Serveaux Marianne,
Cohen Julien,
Darmon Patrice
Publication year - 2017
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.12837
Subject(s) - medicine , interquartile range , diabetes mellitus , population , micronutrient , malnutrition , weight loss , endocrinology , obesity , environmental health , pathology
Aim The main cause of malnutrition in haemodialysis patients is a spontaneous decline in energy and protein intakes. This study aims to report the dietary energy intake (DEI), dietary protein intake (DPI), and dietary micronutrient intake in a French HD population, to report factors associated with a low DPI and DEI, and to analyze if nutritional intake was correlated with nutritional status. Methods We conducted an observational cross‐sectional study in a haemodialysis population of 87 adult patients in July 2014. Daily nutritional oral intake, handgrip strength, body composition measured by bioimpedancemetry, and biological and dialysis parameters were obtained from medical records. Statistical analyses of parameters associated with DEI and DPI were performed. Results The median age (interquartile range) of the population was 77.3 [71.1; 84.8] years, 57.5% were men, and 52.9% had diabetes mellitus. Median weight‐adjusted DEI was 18.4 [15.7;22.3] kcal/kg per day (1308 [1078; 1569] kcal/day), and median weight‐adjusted DPI was 0.80 [0.66; 0.96] g/kg per day (57.5 [47.1; 66.8] g/day). In multivariate analysis, weight‐adjusted DEI was statistically lower in patients with diabetes (coefficient [95%CI] –3.81[−5.21;‐2.41] kcal/kg per day; P = 0.01) but was not associated with the others parameters. When DEI was not adjusted for weight, diabetes was no longer associated with DEI, but female gender (−178[−259;–961] kcal/day; P = 0.03) and a higher Charlson comorbidity index (−30[−44;–15]; P = 0.04) were associated with a lower calorie intake. Results for DPI were similar except that the Charlson comorbidity index did not reach significance. Conclusions Diabetes is an important factor associated with low dietary intake in haemodialysis patients. Restrictive regimens should be prescribed cautiously in haemodialysis patients, especially in those with diabetes.