Avaliação nutricional de pacientes com lesão renal aguda de um hospital de ensino

Abstract

Introduction: The nutritional status is relevant to improve the quality of life of Acute Kidney Failure (AKF) patients, not only to maintain life, but also in the therapeutic context. Objectives: To identify the nutritional intervention to improve the quality of life of AKF patients in a literature review, to assess and associate the nutritional status of AKF patients with the sociodemographic and clinical characteristics and nutritional parameters at a teaching hospital in the State of São Paulo, Brazil. Method: An integrative review was undertaken in the databases Latin American and Caribbean Health Science Literature (LILACS) e Medical Literature Analysis and Retrieval System on-line (MEDLINE) between January 2008 and July 2013. Cross-sectional study of 102 AKF patients at a teaching hospital in the interior of the State of São Paulo, attended by the inter-consultation team from the nephrology service between June and December 2013. The data collection instruments were a form with the sociodemographic, clinical and nutritional variables and the Global Subjective Assessment, modified to assess and interpret the nutritional status. Results: The integrative review of 14 articles demonstrated that the effective nutritional interventions to improve the quality of life of AKF patients are daily nutritional monitoring and nutritional therapy. Few studies were verified about nutritional interventions in AKF patients to improve the quality of life, published particularly in 2009 and in specialized nutrition and nephrology journals. The sociodemographic profile of AKF patients was female (62.75%), with a partner (60.78%), inactive (63.73%), with a mean age of 62.46±16.94 years. The clinical parameters were: non-smokers (88.24%), non-alcohol consumers (84.31%), preliminary kidney disease (50.98%), non-diabetic (55.48%), hypertensive (56.86%), non-dyslipidemic (88.24%), non-obese (90.20%) and from a clinical specialty (59.80%). The nutritional parameters showed the use of an oral diet (85.29%), weight loss superior to 10% (70.59%) and interpreted as mild risk/malnutrition (91.18%). The variables current weight (P=0.048) and systolic blood pressure (P=0.041) were influenced by the patients’ nutritional status. The results showed no significant association between the nutritional status and the other sociodemographic and clinical variables and nutritional parameters assessed. Conclusion: Good nutritional conditions influence the improvement in the quality of life of AKF patients. The assessment of the nutritional status and the monitoring of acute renal patients are fundamental for the early detection of malnutrition and prevention of morbidities and mortality.