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Advisor(s)
Abstract(s)
Introdução: A desnutrição urémica define-se como a perda progressiva de
proteínas, quer somáticas, quer viscerais, podendo apresentar-se como uma situação
mista de desnutrição proteica e calórica, desnutrição proteica simples ou obesidade
sarcopénica. Dada a sua elevada prevalência nos doentes em hemodiálise e sua
correlação com aumento da taxa de mortalidade e número de hospitalizações, torna-se
fundamental estudar a utilidade dos diversos instrumentos de avaliação do estado
nutricional que, permitindo um diagnóstico precoce, possam ajudar a prevenir formas
mais graves desta condição.
Objetivos: Realizar uma revisão da literatura existente no âmbito da desnutrição no
doente em programa regular hemodiálise, designadamente no que diz respeito aos
instrumentos de avaliação do estado nutricional, critérios de diagnóstico da
desnutrição urémica e sua importância e pertinência neste domínio.
Metodologia: O método utilizado foi a pesquisa de literatura na plataforma
PubMed, utilizando os descritores que se seguem: “hemodialysis”, “chronic kidney
disease”, “protein wasting syndrome”, “body composition”, “metabolism”,
“inflammation”. Foram incluídos artigos, nomeadamente artigos de revisão, estudos
transversais e estudos prospetivos de relevo, para além de guidelines e documentos de
consenso sobre este tema que cumpriam os critérios de inclusão.
Conclusões: Após a realização da revisão da literatura selecionada, é possível
concluir que a desnutrição urémica não deve ser diagnosticada utilizando um único
instrumento de avaliação, mas sim através da recolha de diversos parâmetros, sejam
eles bioquímicos, antropométricos ou obtidos através de equipamentos capazes de
avaliar a composição corporal. Também é evidente a necessidade de utilizar critérios
unificados que sejam aceites internacionalmente e que uniformizem o diagnóstico desta
entidade. Deste modo, será possível avaliar os doentes em risco e intervir o mais
precocemente possível, com vista a melhorar a qualidade de vida destes doentes e os
resultados clínicos em termos de morbilidade e mortalidade.
Introduction: Protein Wasting Syndrome defines as a progressive loss of proteins, either somatic or visceral, and it can present itself as mixed situation of caloric and protein malnutrition, simple protein malnutrition or sarcopenic obesity. Give its high prevalence among hemodialysis patients and its correlation with the increase in mortality and hospitalization numbers, it’s essential to study the use of different nutritional assessment tools that, allowing an early diagnosis, can help prevent serious modes of this condition. Aim: To review the existing literature regarding malnutrition in patients on a regular hemodialysis program, namely the nutritional status assessment tools, diagnostic criteria for protein wasting syndrome and its importance in this regard. Methods: Search of PubMed database was undertaken, using the following search terms: “hemodialysis”, “chronic kidney disease”, “protein wasting syndrome”, “body composition”, “metabolism”, “inflammation”. Articles were included, namely review articles, cross-sectional studies, and relevant prospective studies, in addition to guidelines and consensus documents on this topic that met the inclusion criteria. Conclusions: After reviewing the selected literature, it is possible to conclude that Protein Wasting Syndrome should not be diagnosed using a single assessment tool, but rather by collecting several parameters, whether biochemical, anthropometric, or obtained through equipment that is able to assess the body composition. The need to use unified criteria that are accepted internationally and that standardize the diagnosis of this entity is also evident. In this way, it will be possible to assess patients at risk and intervene as early as possible, hoping to improve the quality of life of these patients and other clinical outcomes as mortality.
Introduction: Protein Wasting Syndrome defines as a progressive loss of proteins, either somatic or visceral, and it can present itself as mixed situation of caloric and protein malnutrition, simple protein malnutrition or sarcopenic obesity. Give its high prevalence among hemodialysis patients and its correlation with the increase in mortality and hospitalization numbers, it’s essential to study the use of different nutritional assessment tools that, allowing an early diagnosis, can help prevent serious modes of this condition. Aim: To review the existing literature regarding malnutrition in patients on a regular hemodialysis program, namely the nutritional status assessment tools, diagnostic criteria for protein wasting syndrome and its importance in this regard. Methods: Search of PubMed database was undertaken, using the following search terms: “hemodialysis”, “chronic kidney disease”, “protein wasting syndrome”, “body composition”, “metabolism”, “inflammation”. Articles were included, namely review articles, cross-sectional studies, and relevant prospective studies, in addition to guidelines and consensus documents on this topic that met the inclusion criteria. Conclusions: After reviewing the selected literature, it is possible to conclude that Protein Wasting Syndrome should not be diagnosed using a single assessment tool, but rather by collecting several parameters, whether biochemical, anthropometric, or obtained through equipment that is able to assess the body composition. The need to use unified criteria that are accepted internationally and that standardize the diagnosis of this entity is also evident. In this way, it will be possible to assess patients at risk and intervene as early as possible, hoping to improve the quality of life of these patients and other clinical outcomes as mortality.
Description
Keywords
Composição Corporal Desnutrição Doença Renal Crónica Hemodiálise Instrumentos de Avaliação e Diagnóstico