Prevalence Of Hospital Malnutrition In Renal Patients

Abstract

The prevalence of protein energy wasting varies enormously depending on definition and parameters used. Most evidence include clinical stable patients only. There is few evidence in pre dialysis patients. The purpose of this study was to assess nutritional status at hospital admittance of renal patients NKF-DOQI 2–5 predialysis and dialysis patients and its association with morbidity and mortality. Nutritional assessment was done during the first three days of admission to the hospital with a composite nutritional index in 907 renal patients (589 pre dialysis and 318 dialysis). Length of stay and frequency of hospitalizations, mortality and comorbidities were registered. ANOVA, Cox and Kaplan-Meier statistics were done where needed. A prevalence of 76% of moderate to severe malnutrition was found to the general population being more prevalente in dialysis patients (81% dialysis vs 73% pre dialysis) (p≤0.05). Hazard ration of malnutrition was 2.07 and 2.57 in DOQI 4 and 5 non dialysis patients respectively (p<0.05). Hazard ratio of mortality was 2.91 and 8.67 in moderate and severe malnutrition respectively predialysis patients (p<0.05) and 2.72 and 3.22 in moderate and severe malnutrition respectively in dialysis patients (p<0.05). Survival during the follow up was inferior in severe malnutrition in both groups (p<0.05). In conclusion a prevalence of 76% of malnutrition was found in this cohort of hospitalized renal patients, greater than reported elsewhere being in dialysis patients more prevalent. Malnutrition was negatively associated with survival.