| dc.description.abstract | Elderly hemodialysis patients particularly suffer from protein-energy wasting syndrome due to age-related
physiological changes. We carried out an observational study from 1 to 30 April 2016 involving 31 elderly
hemodialysis patients in the center of Cahors University Hospital. We intended to check how close the 3 methods of
nutritional evaluation were, namely ingesta, albumin/prealbumin association and Subjective Global Assessment. We
trialed the nutritional status of each patient using the above methods.
The mean age was 77.7 ± 7.07 years with M/F ratio of 0.63. Exposure to dialysis was 40.61 ± 67.88 months on
average. The mean BMI was 26.67 ± 9.17 kg/m2. The average daily calorie and protein intake was 1297.61 ±
321.73 Kcal and 52.87 ± 9.89 g, respectively. The average branchial perimeter was 27.53 ± 2.47 cm with a mean
triceps skinfold of 9 ± 0.7. The daily protein intake assessed by the nPCR was 0.95 ± 0.21 g/kg/day. The mean
albumin and pre-albumin levels were 37.32 ± 1.41 g/l and 283.22 ± 35.35 mg/l. The average Kt/V was 1.98 ± 0.35.
According to the SGA, 26 (83.87%) were in good nutritional status (subgroup 1), 3 (9.67%) were suffering from mild
undernutrition (subgroup 2) and 2 (6.46%) had acute undernutrition (subgroup 3). Relying on albumin and pre-
albumin levels, 18 (58.06%) were in good nutritional status, 6 (19.36%) had mild undernutrition and 7 (22.58%)
acute undernutrition. According to the ingesta, 2 (6.46%) patients were in subgroup 1, 8 (25.81%) patients in
subgroup 2 and 21 (67.74%) in subgroup 3. No agreement was found between the 3 evaluators of nutritional status
(kappa to assess SGA and albumin-pre-albumin association at -0.075 [95% confidence interval: -0.175 to 0.024];
kappa as a measurement for SGA and ingesta at 0.073 [95 % range: -0.007 to 0.153], kappa for albumin-pre-
albumin combination and ingesta at 0.034 [95% confidence interval: -0.058 to 0.126]).
Disjunction between the three nutritional evaluators used in our study, in addition to inherent bias in the low
number of staff, provides information on the nutritional problems of elderly hemodialysis patients, especially
underestimation of nutritional surveys in relation to actual energy intake, nutritional impact of the physiological and
socio-economic changes that accompany aging and the lack of nutritional methods and standards specific to this
category of population. | en_US |
