Resumo

RODRIGUES, Rosária et al. Predictive value of bioelectrical impedance analysis parameters in the mortality of patients on haemodialysis. Port J Nephrol Hypert [online]. 2014, vol.28, n.4, pp.309-317. ISSN 0872-0169.

Background: Protein-energy wasting is a very common complication in hemodialysis patients and influences their survival. All hemodialysis patients should have their nutritional status evaluated regularly using multiple methods. The bioelectrical impedance analysis has been widely used in the nutritional assessment. The objective of this study was to evaluate, for a period of 7 years, to the prognostic value of the parameters of bioelectrical impedance analysis on mortality in hemodialysis patients. Methods: A retrospective, observational study, including 301 patients in hemodialysis at baseline. During the study period 96 patients died, 46 patients were transplanted, 21 were not followed by Nutritionist, 49 were transferred to another clinic and 4 underwent treatment changes. The parameters assessed at baseline were: demographic and clinic data (age, gender, etiology of chronic kidney disease and co-morbidity), dialysis data (type and duration of hemodialysis, dialysis vintage, vascular access and Kt/V), biochemical parameters, body mass index, bioelectrical impedance analysis, subjective global assessment and PNAn. Results: According to Kaplan-Meier, Mantel-Hansel and Cox regression analysis the following variables were predictors of mortality: age, dialysis vintage, body mass cell index<8 kg/m2, phase angle<4.9º, extracellular mass/body cell mass ratio and PNAn<1.2 g/kg/day were selected as potential predictors of mortality. In multivariate analysis, after adjusting for others mortality risk factors (age, dialysis vintage, serum albumin, PNAn, inflammatory state, presence of diabetes and cardiovascular co-morbidity), only patients with lower phase angle were found to be at high risk for mortality. Conclusion: The present study shows that bioelectrical impedance analysis parameters (phase angle, body mass cell index and extracellular mass/body cell mass ratio) and PNAn were the only nutritional markers associated with mortality in this cohort of hemodialysis patients. Therefore we conclude that the bioelectrical impedance analysis is a promising technique for assessing the nutritional status of patients on hemodialysis and may be used as a prognostic indicator of mortality in this population.

Palavras-chave : Bioelectrical impedance analysis; mortality; nutritional assessment; protein energy wasting.

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