Associações entre ingestão energética, proteica e de fósforo em pacientes portadores de doença renal crônica em tratamento hemodialítico Associations between energy, protein, and phosphorus intakes in patients with chronic kidney disease on hemodialysis

Abstract

INTRODUÇÃO: A nutrição desempenha papel fundamental nas doenças renais. A recomendação nutricional deve ofertar uma dieta hiperproteica, adequada em energia e fósforo segundo o Kidney Disease Outcomes Quality Initiative (K/DOQI). É necessário controlar e/ou prevenir as complicações da Doença Renal Crônica (DRC), pois ela impõe desafios clínicos diretamente ligados ao estado nutricional. OBJETIVO: Investigar as associações entre a ingestão energética, proteica e de fósforo em pacientes em hemodiálise (HD). PACIENTES E MÉTODOS: Estudo observacional envolvendo 72 pacientes em HD, em dois hospitais de Porto Alegre/RS/Brasil. Foram coletados dados referentes ao perfil antropométrico (peso, altura e índice de massa corporal - IMC) e do registro alimentar de três dias (ingestão de energia, proteína e fósforo). O teste de correlação de Spearman foi utilizado para avaliar as associações entre as variáveis do registro alimentar (p INTRODUCTION: Nutrition plays an important role in kidney disease. The nutritional recommendation is to offer a high-protein diet, adequate in energy and phosphorus according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. Control and/or prevention of the complications of chronic kidney disease (CKD) are essential, because CKD poses clinical challenges directly related to the nutritional status. OBJECTIVE: To investigate the possible associations between energy, protein, and phosphorus intakes in hemodialysis (HD) patients. METHODS: Observational study involving 72 HD patients from two hospitals in the city of Porto Alegre, Brazil. Anthropometric data [weight, height, body mass index (IMB)] were collected and three-day food intake (daily energy, protein, and phosphorus intakes) was recorded. Spearman correlation was used to evaluate associations between food intake variables (p < 0.05). RESULTS: The energy, protein, and phosphorus intakes were 28 ± 10 kcal/kg/day, 1,1 ± 0.4 g protein/kg, and 958 ± 374 mg/day, respectively, and the first two were below the K/DOQUI recommendations. A strong positive correlation was observed between the variables. DISCUSSION: Assessing the nutritional profile is essential, because correlations between nutrients occur. It is worth emphasizing that the K/DOQI guidelines are not met by the patients. CONCLUSION: A positive association between the intakes of energy, protein, and phosphorus is observed in the diet of HD patients. The dietary control of these nutrients is essential to manage CKD complications. Therefore, nutritional evaluation in dialysis units is crucial to define the dietary profile of patients and to adjust their prescriptions.

Keywords

• insuficiência renal crônica
• hemodiálise
• energia
• proteína
• fósforo
• chronic renal failure
• hemodialysis
• energy
• protein
• phosphorus