ABSTRACT
The evaluation of the nutritional state of patients on maintenance haemodialysis is one of the main aspects involved in the prescription of treatment, since malnutrition is frequent among these patients and is a very important risk factor. We studied the albumin levels and the levels of several rapid interchange proteins (prealbumin, transferrin, cholinesterase) in 106 patients with chronic renal failure on haemodialysis. The proteic catabolism rate (pcr) and total dose on normalized dialysis (KT/V) was also determined in these patients, in accordance with the kinetic urea model. Anthropometrical measurements were taken (dry weight following haemodialysis, skin fold of the triceps and muscular circumference of the arm) in 65 patients. The average levels of the proteins studied were within normal laboratory limits, except for albumin, which was slightly lower. The greater frequency of infranormal levels corresponded to albumin (57%); the protein least altered was prealbumin (14.7%), although 70.4% of patients showed lower levels of this protein compared to those considered as indicating a poor prognosis (30 mg/day). The estimated daily proteic intake, according to the proteic catabolism rate, was lower than the recommended rate in 58% of our patients, this was not correlated with any of the proteins studied, and was significantly lower in the group of patients whose dialysis dose was too low. Although the anthropomorphic parameters did not correlate with any protein, the average levels of prealbumin were significantly lower in patients with infranormal levels of dry weight and skin fold of the triceps. The albumin, prealbumin, transferrin and cholineserase levels were not affected by treatment with erithropoyetin, haemodialysis buffer bath or type of membrane used.
