Nutritional status of maintenance dialysis patients: Low lean body mass index and obesity are common, protein-energy wasting is uncommon.

Nutritional status of
maintenance dialysis patients: Low lean body mass index and obesity is common,
protein-energy wasting is uncommon

Abstract

Background
and aims: Maintenance dialysis patients are at increased risk of
abnormal nutritional status due to numerous causative factors, both nutritional
and non-nutritional. The present study assessed
the current prevalence of protein-energy wasting, low lean body mass index and
obesity in maintenance dialysis patients, and compared different methods of
nutritional assessment.

Methods: In
a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we
performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip
circumferences), and determined plasma albumin and normalized protein catabolic
rate in order to assess the prevalence of protein-energy wasting, low lean body
mass index and obesity in these patients.

Results: Seventy-nine eligible maintenance dialysis
patients participated. The prevalence of protein-energy wasted patients was 4%
(95% CI: 2-12) as assessed by the coexistence of low lean body mass index and
low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as
assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean
body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity
varied considerably, depending on nutritional assessment methodology.

Conclusions: Our data indicate that protein-energy wasting is uncommon, whereas low
lean body mass index and obesity are frequent conditions among patients in maintenance
dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in
the future. In order to clearly distinguish between shortage, sufficiency and
abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest
the simple measurements of lean body mass index and fat mass index.