Características clínicas, do consumo dietético e dos níveis séricos de fósforo de indivíduos com Doença Renal Crônica em hemodiálise

• Ano de defesa: 2013
• Autor(a) principal: Silva, Sandra Tavares da
• Orientador(a): Ribeiro, Rita de Cássia Lanes
• Banca de defesa: Bastos, Marcus Gomes
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Viçosa
• Programa de Pós-Graduação: Mestrado em Ciência da Nutrição
• Departamento: Valor nutricional de alimentos e de dietas; Nutrição nas enfermidades agudas e crônicas não transmis
• País: BR
• Palavras-chave em Português: Alimentos - Consumo; Insuficiência renal crônica - Tratamento; Fósforo; Nutrição - Avaliação; Terapia renal substitutiva; Cognição
• Palavras-chave em Inglês: Food - Consumption; Chronic renal failure - Treatment; Phosphorus; Nutrition - Evaluation; Renal replacement therapy; Cognition
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::NUTRICAO
• Link de acesso: http://locus.ufv.br/handle/123456789/2789

The aim of this study was to analyze epidemiological, clinical and dietary intake of individuals with Chronic Kidney Disease (CKD) on hemodialysis (HD) in multidisciplinary care. This study observational and analytical was conducted at Nephrology Service, in Viçosa-MG, with participation of 75 individuals. Information about clinical, biochemical and anthropometric dates were obtained from medical records. We applied the Mini Mental State Examination to avaluation memory and cognition (MC), and two 24-hour dietary recalls and Frequency Questionnaire Food Consumption for characterization of food intake and interview about the diagnosis of CKD. Statistical analysis consisted of comparison tests (Student t test, Mann Whitney, Kruskal Wallis, ANOVA and chi-square), correlation (Pearson and Spearman), post hoc Tukey and Odds Ratio. Most subjects studied were men (60%) and the main causes of CKD are diabetes mellitus and hypertension. Eight subjects had impaired MC and were excluded from further analysis. There were no differences in the clinical and biochemical characteristics between patients with and without impairment of MC. Most of the participants were normal weight (55.4%) and food consumption, according to nutritional status, was nearby to the energy and protein recommendation. Regarding phosphorus, 58.18% of the subjects had serum phosphorus levels greater than 5.5 mg / dL, but the intake of calcium was within recommended. Only 12 individuals were considered adherent to phosphate binders by calculating the percentage of adherence, but there were no statistical differences regarding serum phosphorus levels between individuals adherent or not to prescribed phosphate binders. The diagnosis of CKD in 40% of participants was done in hospitals, where the majority of individuals who did not performed conservative treatment (CT) received diagnosis. Individuals who underwent CT showed better biochemical parameters, especially when the weather monitoring predialysis was more than six months. Time hemodialysis more than 48 months resulted in worsening biochemical parameters and increase the chance of showing body mass index less than 23.5 kg / m2 and serum parathyroid hormone values above 300pg/dL, independent of the realization of TC. Food is an important element of treatment of CKD and guidance on appropriate caloric intake and protein are essential, in addition to the restriction of processed foods, mainly to reduce the intake of phosphorus. The care of phosphate binder medication contributes to treat hyperphosphatemia, common in HD. The effects of TC were most evident in early HD, reinforcing the importance of multidisciplinary care during HD for maintaining and extending the benefits of TC and improved metabolic control even individuals without such treatment.