NUTRITIONAL PROFILE AND INFLAMMATORY STATUS OF STABLE CHRONIC HEMODIALYSIS PATIENTS AT NEPHROLOGY DEPARTMENT, MILITARY HOSPITAL RAWALPINDI
Abstract
Background: Protein-energy malnutrition (PEM) is common in the haemodialysis population.Identification and management of these patients can result in significant reduction in morbidity
and mortality. Aim of the study was to find the prevalence of PEM in otherwise stable
haemodialysis patients at Military Hospital Rawalpindi at a single point in time with the help of
established biochemical and physical markers. Material and Methods: Height, dry weight and
body mass index (BMI) were recorded for 64, stable, 14-75 year-old patients who were on
haemodialysis for 3 months. Blood samples were drawn (pre-dialysis) for complete blood count,
serum C-reactive protein, serum total protein, serum albumin and serum Creatinine. Ideal body
weights and BMI were obtained from Pakistan Army Selection and Recruitment standards.
Results: Out of 64 patients 43 (67%) were males. Mean age was 44.514.3 yr. Mean haemoglobin
was 8.842 g/dl. Fifty-seven patients (89%) had haemoglobin 11 g/dl. Pearson correlation
coefficient (r) with albumin was significant (p=0.01). The mean serum albumin was 34.24.25 g/l.
Serum albumin of less than 40 g/l in 58 patients (90.6%). C-Reactive protein was available for 58
(90.6%) of patients. It was positive in 23 (35.9%) and was associated with a lower mean serum
albumin (32.7 g/l vs 35.4 g/l) which was statistically significant (p=0.017). There was no
significant relationship between the lymphocyte count and albumin levels. However, the Pearson
correlation of albumin with the total WBC count gave a p value of 0.05. Mean BMI was 19.82.9
kg/m2. Thirty-seven (57.8%) patients had BMI in the normal range (18.5-24.6 kg/m2) and 24
(37.5%) were below normal (14.6-18.3 kg/m2). Correlation of albumin with BMI and serum
creatinine was not significant (p= 0.46 and 0.53 respectively). Conclusion: Serum albumin is a
strong marker of malnutrition but needs to be associated with other physical and inflammatory
parameters to correctly identify malnourished haemodialysis patients.
Key Words: Haemodialysis; nutrition; albumin; C-reactive protein; body mass index
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