Nutrición y Tolerancia a la diálisis

Abstract

The nutritional status is one of the most studied aspects of the patient in hemodialysis, due to its proven relationship with morbimortality and survival, and because imbalances such as caloric-protein malnutrition acquire greater relevance as it is a very frequent condition in dialysis units, estimating that between 30 and 70 % of patients present some degree of malnutrition, according to the series studied1,2,3. The causes that can explain this high incidence of undernutrition are very varied, although it seems that the main one is the reduction in intake, probably caused by uremia, without losing sight of other conditions such as the dietary restrictions to which these patients are subjected2,3,4. In view of this perspective, nutritional assessment in haemodialysis is becoming consolidated as an essential aspect of patient care5,6 , and there are more and more units that carry out periodic assessments to detect patients at risk of undernutrition or malnourishment, and prevent imbalances by acting early with health education (dietary advice) or by providing supplements, before complications arising from a deficient nutritional status appear7,8. However, on occasions and for different reasons, stable patients on haemodialysis can evolve rapidly from an adequate nutritional state to a state of severe caloric-protein malnutrition, and this is detected when the first clinical manifestations appear, being necessary in these cases a series of rapid actions to revert the previous situation of stability, focusing these actions on ensuring the necessary dietary contributions, ensuring also an adequate dialysis.