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Importância da avaliação bioquímica mensal na triagem de pacientes com desnutrição em hemodiálise

2010; Sociedade Brasileira de Nefrologia; Volume: 32; Issue: 4 Linguagem: Inglês

10.1590/s0101-28002010000400004

ISSN

2175-8239

Autores

Margaret de Castro, Flávia Chiaradia Andrade de Oliveira, Ana Castello Branco da Silveira, Kátia de Barros Correia Gonzaga, Magdaleni Xagoraris, Jerônimo Ruiz Centeno, José Adilson Camargo de Souza,

Tópico(s)

Pharmacological Effects and Toxicity Studies

Resumo

Malnutrition is a frequent complication in patients on hemodialysis and early diagnosis is important to reduce the morbidity and mortality of treatment.To investigate the usefulness of biochemical tests performed monthly in order to identify hemodialysis patients with malnutrition.The nutritional status of 252 patients was evaluated by objective and subjective global assessment, and the patients classified as malnourished and not malnourished. Then, during 4 consecutive months, serum creatinine, phosphorus, urea pre-and post-dialysis and Kt/V were recorded for calculation of averages. After analysis of these variables by the ROC curve we calculated the sensitivity and specificity of these parameters to identify patients with malnutrition.In ROC curve, the area under the curve for urea was 0.683, 0.71 for phosphorus, 0.724 for Kt/V and 0.765 for creatinine. For values of urea ≤ 90 mg/dL, phosphorus ≤ 4.2 mg/dL, Kt/V ≥ 1.6 and creatinine ≤ 6.5 mg/dL, the specificity ranged between 80% and 88% and sensitivity between 26% and 51%. The negative predictive value ranged between 90% and 92% and positive predictive value between 23% and 32%. The association of two or more of these índices did not change significantly these values.Our results suggest that serum urea ≤ 90 mg/dL, creatinine ≤ 6.5 mg/dL, phosphorus ≤ 4.2 mg/dL, and Kt/V ≥ 1.6 can be used for screening patients with malnutrition. However, using these cutoffs the parameters tend to overestimate the number of patients with malnutrition.

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