Journal of Regional Section of Serbian Medical Association in Zajecar
Year 2004     Volumen 29     Number 2
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UDK 616.61-78—06:616.089 ISSN 0350-2899, 29(2004) 2 p.73-79
Original paper

Comparative Analysis of Malnourished and Well-Nourished Patients
on Regular Haemodialysis

Biserka Tirmenštajn Janković (1), Jasmina Strajnić (2)
(1) Odeljenje nefrologije i hemodijalize, Zdravstveni centar Zaječar
(2) Radiološka služba, Zdravstveni centar Zaječar



  Summary: Protein-energy malnutrition is a common and well-known risk factor for increased morbidity and mortality in maintenance haemodialysis (HD) patients. Nevertheless, the pathophysiological link between malnutrition and poor outcome remains to be clarified. The present study was undertaken to investigate differences in clinical characteristics (age, gender, duration of HD, diabetes mellitus, smoking), nutritional [body mass index (BMI), lean body mass (LBM), haemoglobin, s-albumin, s-creatinine, s-urea], vascular [intima-media thickness (ITM),lumen-diameter (LD), cross-sectional intima-media area (cIMarea), presence of plaques], lipid (total cholesterol, LDL, HDL,VLDL, triglycerides) and inflammatory (CRP, fibrinogen, ESR) parameters between the malnourished and well-nourished patients on regular haemodialysis. In this cross-sectional study we studied 43 patients ( 27 M, 16 F, the mean age 57.8 12 years). Subjective global assessment (SGA) was used to evaluate the overall protein-energy nutritional status.
According to SGA, 53 % of patients had a normal nutritional status (SGA 1), whereas 47% had signs of mild to severe malnutrition (SGA 2-4). There were significant differences in mean values of nutritional parameters: haemoglobin, s-albumin, creatinine, BMI and LBM between the groups. Atherosclerotic cardiovascular disease were significantly more prevalent among patients with SGA 2-4 (p = 0.001). Compared to the well-nourished group, total cholesterol and LDL (p < 0.05) were significantly lower in the malnourished group, while CRP (p < 0.001) and fibrinogen (p < 0.01) levels were higher. Our results confirmed the relationship between malnutrion and inflammation in patients on chronic haemodialysis and suggested the necessity of an early prevention and therapy.
Key words: haemodialysis, nutritional status, malnutrition, subjective global assessment, inflammation

Note: full text in Serbian
Napomena: kompletan tekst rada na srpskom jeziku

  Corresponding Address:
Biserka Tirmenštajn-Janković
Naselje Kraljevica C2 / II stab 13, 19000 Zaječar
e-mail: tribally@ptt.yu
  Paper received: 29.12.2003
Paper accepted: 22.02.2004
Published online: 05. 08. 2004
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