Indicadores nutricionais e qualidade de vida de idosos com doença renal crônica em tratamento hemodialítico

Abstract

Elderly patients with chronic kidney disease undergoing hemodialysis are at greater risk of malnutrition due to dietary restrictions, intradialytic amino acid loss, anorexia and infectious intercurrences, resulting in worsening of health-related quality of life. The objective of this study was to evaluate the effect of treatment time and nutritional indicators on the quality of life of elderly patients with chronic kidney disease on hemodialysis. This was a descriptive, analytical, quantitative and cross-sectional study. The study sample consisted of 122 elderly people of both sexes, with chronic kidney disease and on hemodialysis for at least three months in two units of a renal clinic in the city of Santa Maria, RS, from March to July, 2018. Patients with acute renal failure, who had difficulty understanding the interview and who used enteral feeding, were excluded from the study. The data collection was performed through an interview and consultation of the patient's chart. The variables analyzed were socio- demographic data (age, sex, skin color, marital status, schooling and income), clinical history of renal disease (baseline disease, maintenance time on hemodialysis, associated comorbidities, nutritional indicators (anthropometric data, food, and biochemical tests) and quality of life. The Kolmogorov-Smirnov test, Student's t test, Mann-Whitney U test, Chi-square test, Pearson correlation test and Spermann correlation test were used for statistical analysis. The study was approved by the Research Ethics Committee of the Federal University of Santa Maria under No. 2,545,211, and the majority of the results were male (59.00 %), with a mean age of 70.31 ± 6.92 years, white (71.30%), companion (59.80%), schooling less than 5 years of study (68.00%), , income greater than 2 minimum wages ( 52.50%) and attended by the Unified Health System - SUS (72.10%). There was a significant difference in dietary intake in the elderly group with the highest hemodialysis time (≥3 years): g / day (p = 0.024), total calories (p = 0.034), carbohydrates , phosphorus (p = 0.029) and potassium (p = 0.016); biochemical tests: ferritin (p = 0.001), Kt / v (p = 0.010); there being no significance for anthropometric data and health-related quality of life among the elderly groups. Regarding the association between nutritional indicators and health- related quality of life, there was a correlation between the anthropometric variables and the categories: Team Stimulation / Dialysis, Social Support, Pain, Social Function, Energy / Fatigue and List of Problems / Symptoms; Physical function, Pain, General health, Welfare-emotional, Social function, Energy / fatigue, List of problems / symptoms, Renal disease overload, Sexual function and Team / dialysis stimulation; food consumption presented a correlation of macronutrients with Physical functioning, Physical function, Pain, General health, Well-emotional, List of problems / symptoms, Cognitive function and Sexual function and Micronutrients with Physical functioning, Physical function, Pain, General health, Emotional well-being, Emotional function, Social function, Energy / fatigue, List of problems / symptoms, Cognitive function, Quality of social interaction and Sexual function. It was concluded that the elderly with a longer time of hemodialysis treatment presented higher risk for protein-energy malnutrition, high phosphorus, low potassium intake and elevated ferritin, a behavior not observed in quality of life. Still, nutritional indicators directly influenced the health-related quality of life categories of the elderly.