Identificación de pacientes de riesgo nutricional por 3 métodos de cribado distintos / No disponible

Identificar precozmente a los pacientes de Riesgo Nutricional es fundamental para actuar de forma inmediata sobre ellos y aplicar el aporte nutricional correcto a aquellos que lo necesiten. Para ello existen varios métodos de cribado o screening. Objetivos: 1.- Determinar el índice de riesgo nutricional por 3 métodos de gran sensibilidad.2.- Comprobar si existe concordancia en el resultado obtenido con cada uno de ellos. Material y métodos: Se estudian 184 pacientes mayores de edad (92<65 años y 92≥65años) ingresados en 6 hospitales públicos de Galicia, a quienes se aplican los protocolos de estudio para 3 métodos de cribado nutricional perfectamente validados que determinan pacientes de Riesgo Nutricional. Se valoran cambios recientes en el peso, albúmina sérica, concentración de linfocitos e ingesta y diagnóstico al ingreso y se determina el porcentaje de pacientes de riesgo con cada método. Contrastamos los porcentajes y comprobamos si existe concordancia entre los resultados. Resultados: El Índice de Riesgo Nutricional lo definen los pacientes con riesgo de desnutrición hallados por cada parámetro: Elmore -IR.= 20,1%; Ulíbarri – IR. = 51,1%, Cardona –IR. = 48,9%El Coeficiente de correlación de Spearman muestra una significación de 0,00, lo que suponeuna concordancia entre los pacientes de riesgo nutricional definidos por cada uno de losíndices. Conclusiones: 1.- El Índice de Riesgo determinado por cada parámetro está dentro del estándar habitual de desnutrición Hospitalaria. 2.-Los 3 Índices de Riesgo muestran una correlación significativa entre ellos, es decir, que detectan los mismos pacientes como pacientes d eriesgo (AU)

To identify precociously patients at nutritional risk is essential to act immediately to apply nutritional support is needed. There are several screening methods. Objectives: 1.- To determine nutritional risk by 3 methods of great sensitivity. 2.- To establish the concordance of results obtained between methods. Material and Methods: We studied 184 adult patients (92<65 years and 92≥65 years) admitted in 6 publics hospitals of Galicia, who were applied for study protocol for 3 validated nutritional screening methods that determine nutritional at risk patients; evaluation included recent weight changes, serum albumin, lymphocyte count, ingestion and diagnosis at admittance, and we determined the percentage of risk patients with each method. We contrasted percentages and studied concordance between results. Results: Nutritional Risk Index is defined by patients at risk founded by each parameter: Elmore- IR.= 20,1%; Ulíbarri – IR. = 51,1%, Cardona– IR. = 48,9%Spearman’s correlation coefficient shows significant relation of de 0,00, that implies a concordance between at risk patients defined bay each index. Conclusions: 1.- Risk index defined by each parameter is between usual hospital malnutrition standards. 2.- All 3 risk index show significant correlation; that means that they show significant correlation and detect same patients as at risk (AU)

[Nutrition and chronic renal failure]. / Nutrición e insuficiencia renal crónica.

The causes of malnutrition in chronic terminal kidney failure are reviewed in the situation both before and after dialysis, as are the malnutrition rates in both circumstances and their treatment. Malnutrition has a high prevalence in terminal kidney patients, partly as a result of the therapeutic restriction on calories and proteins, but also due to the metabolic reactions typical of the disease and to anorexia. In patients subjected to dialytical methods, certain other mechanisms are added. In addition to malnutrition, there are alterations in the metabolism of calcium, phosphorus and potassium, as well as lipids, thus limiting nutritional therapy's ability to restore the nutritional status to normal. An awareness of energy expenditure in chronic terminal kidney failure and the consequences of malnutrition have led to new challenges in nutritional therapy, both in the dose and quality of the proteins, with a debate raging over the advantages of ketoanalogues, and also in the methods for providing nutrients. The ideal nutritional method for repletion is oral administration, but this can be enhanced with artificial support such as oral supplements, parenteral nutrition during dialysis or such alternatives as enteral nutrition at home in the case of chronic kidney problems in children, using percutaneous endoscopic gastrostomy (PEG), in order to nourish the patients and minimize growth disorders.