Nephrology Dialysis Transplantation, Vol 14, Issue 7 1679-1686, Copyright © 1999 by Oxford University Press
M Aparicio, N Cano, P Chauveau, R Azar, , A Flory, M Laville, X Leverve and t French Study Group for Nutrition in Dialysis (FSG-ND)
Background: Despite the severity and the prognosis
value of undernutrition in haemodialysed patients, no large study is
available as yet in Europe. Hence, this French National cooperative Study
aimed to determine the prevalence of undernutrition and its relationship to
dialysis efficacy. Methods: Nutritional status was
determined in 7123 patients (i.e. one-third of the French haemodialysis
population) using body mass index (BMI), predialysis haemoglobin, albumin,
pre-albumin, cholesterol, and also normalized protein catabolic rate (nPCR)
and lean body mass (LBM) calculated from pre- and postdialysis urea and
creatinine. Dialysis treatment was estimated from weekly dialysis time and
KtV determination. Results: Dialysis time was
12.4±2.7 h/week and KtV 1.36±0.36. BMI was below 20
kg/m2 in 24% and the observed/expected LBM ratio
below 90% in 62%. Albumin, pre-albumin and nPCR were below the high-risk
thresholds of 35 g/l, 300 mg/l and 1g/kg/day in 20%, 26% and 35% of
patients, respectively. Pre-albumin was the most representative nutritional
parameter. Albumin, pre-albumin and LBM correlated with nPCR. A dialysis
time above 12 h/week was associated with higher BMI, albumin, pre-albumin
and LBM. LBM was higher in patients with a KtV value > 1.1.
Conclusion: This study showed life-threatening
undernutrition in 20-36% of the studied population, according to
nutritional parameters. Protein intake (estimated by nPCR) and dialysis
efficacy (estimated by dialysis time and KtV) appeared to be major
determinants of nutritional status in this population. Key
words: albumin; haemodialysis; KtV; lean body mass; nPCR;
nutrition; pre-albumin
ORIGINAL ARTICLES
Nutritional status of haemodialyis patients: a French national cooperative study
Service de Néphrologie, Hôpital Pellegrin Tripode, Bordeaux, France; Clinique 'La Résidence du Parc', Marseille, France; AURAD, Gradignan, France; Médicine Interne B, CHG Dunkerque, Dunkerque, France; Service de Néphrologie, Hôpital Lapeyronie, Montpellier, France; Centre de Ressources Informatiques, INSA-Bt 401, Villeurbanne, France; Service de Néphroloigie-Pavillon P, Hôpital E Herriot, Lyon, France; Laboratoire de Bioénergétique, Fondamentale et Appliquée, Université Joseph Fourier, PB 53 X, Grenoble, France; Corresponding author at: Département d'Urgence et de Réanimation-Unitéde Nutrition Parentérale, Hôpital Michallon, BP 217, F-38 043 Grenoble-cedex 9, France. E-mail: xavier.leverve@ujf-grenoble.fr
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