Prevalence of malnutrition for elderly hemodialysis patients.

Introduction: The prevalence of the terminal chronic renal failure treated by hemodialysis is rising steadily especially for the elderly. Its evolution is fraught with complications including protein-energy malnutrition. The aim of this study was to evaluate the predominance of protein-energy malnutrition among elderly hemodialysis patients.

Methods: This cross-sectional descriptive study included 40 elderly hemodialysis patients recruited at the M8 nephrology department of Charles Nicolle Hospital in Tunis. All patients went through a clinical examination, a biological assessment, a dietary survey based on food registration for 3 consecutive days and the calculation of nutritional risk scores (MNA and GNRI).

Results: The Average  of hemodialysis was of 7 ± 3.8 years. The average energy intake of the patients was 25.3 ± 12.3 kcal / kg of ideal weight per day. The weight evolution during the last 6 months preceding the study was marked by a weight loss exceeding the 10 % in 12 % of the cases. A BMI less than 21 kg / m² was noted in 73.7 % of the women and 47.6 % of the men. The brachial circumference was less than 22 cm in 36.8 % of the women and 23.6 % of the men. One-third (32.5 %) of the study population had a calf circumference that is less than 31 cm. Most patients (67.5 %) had hypoalbuminaemia. The predominance of malnutrition according to the 2007 HAS criteria was 71% among hemodialysis patients. The majority of women (78.9 %) and 57.1 % of men had GNRI less than or equal to 98.

Conclusion: Protein-energy malnutrition is a common and serious pathological situation in elderly hemodialysis patients which can be life-threatening.