Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya5900510.26442/00403660.2019.06.000088Research ArticleProtein - energy wasting of haemodialysis patientsJakovenkoA. Aleptin-rulit@mail.ruRumyantsevA. Sh-Pavlov First Saint Petersburg State Medical University15062019916808422012021Copyright © 2019, Consilium Medicum2019Aim. To assess the prevalence of protein - energy wasting (PEW) of haemodialysis patients (HD). Materials and methods. A total of 645 patients receiving treatment with programmatic bicarbonate HD for 8.4±5.3 years, including 345 women and 300 men, the average age was 56.8±12.8 years. Nutritional status was assessed using the method recommended by the Ministry of Health of the Russian Federation (MHRF) (accounting form № 003/U), as well as the method proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). The nature of the change in appetite was determined by the Appetite and diet assessment tool (ADAT) and KDQOL-SF (version 1.3). Evaluation of the adequacy of the diet was performed using filled in patients for 3 days food diaries. Results and discussion. A decrease in appetite was recorded in no more than 5% of patients, while these changes were of a persistent, lasting nature. Inadequate intake of essential nutrients, taking into account the recommendations of the ERBP, was found in 9.7% of patients, while inadequate intake of protein was noted. The prevalence of PEW by the method of MHRF was 75.3%, by the method of ISRNM the prevalence of PEW was 51.2%. There were no statistically significant differences between the patient groups depending on age and the presence of PEW according to the MHRF method (χ2=7.072; p=0.069). Similar data were obtained for the method of diagnostics PEW ISRNM. Statistically significant differences between groups of patients were obtained depending on the duration of HD and the presence of PEW according to the MHRF method (χ2=22.580; r=0.0001). The prevalence of PEW by the MHRF method increases with increasing duration of HD (Rs=0.184; p=0.0001). Similar data were obtained for the method of diagnosis of PEW ISRNM. Conclusion. The prevalence of PEW in haemodialysis patients was 51.2% according to the ISRNM method and 75.3% according to the MHRF method.prevalenceprotein-energy wastinghaemodialysisбелково энергетическая недостаточностьгемодиализраспространенность[Al Ismaili F, Al Salmi I, Al Maimani Y, et al. Epidemiological Transition of End-Stage Kidney Disease in Oman. Kidney Int Rep. 2016;2(1):27-35. doi: 10.1016/j.ekir.2016.09.001][Томилина Н.А., Андрусев А.М., Перегудова Н.Г., Шинкарев М.Б. Заместительная терапия терминальной хронической почечной недостаточности в Российской Федерации в 2010-2015 гг. Отчет по данным Общероссийского Регистра заместительной почечной терапии Российского диализного общества, Часть первая. Нефрология и диализ. 2017;19(4 прил.):1-94. doi: 10.28996/1680-4422-2017-4suppl-1-95][Kang S.S, Chang J.W, Park Y. Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis. Nutrients. 2017;9(4): pii: E399. doi: 10.3390/nu9040399][Obi Y, Qader H, Kovesdy C.P, Kalantar-Zadeh K. Latest consensus and update on protein - energy wasting in chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2015;18(3):254-62. doi: 10.1097/MCO.0000000000000171][Perez Vogt B, Costa Teixeira Caramori J. Are Nutritional Composed Scoring Systems and Protein-Energy Wasting Score Associated With Mortality in Maintenance Hemodialysis Patients? J Ren Nutr. 2016;26(3):183-9. doi: 10.1053/j.jrn.2015.11.003][Sabatino A, Regolisti G, Karupaiah T, et al. Protein - energy wasting and nutritional supplementation in patients with end - stage renal disease on hemodialysis. Clin Nutr. 2017;36(3):663-71. doi: 10.1016/j.clnu.2016.06.007][Gracia-Iguacel C, González-Parra E, Barril-Cuadrado G, et al. Defining protein - energy wasting syndrome in chronic kidney disease: prevalence and clinical implications. Nefrologia. 2014;34(4):507-19. doi: 10.3265/Nefrologia.pre2014.Apr.12522][European best practice guidelines Guideline on Nutrition. Nephrol Dial Transplant. 2007;22(Suppl 2):45-87.][Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein - energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391-8. doi: 10.1038/sj.ki.5002585][Kanazawa Y, Nakao T, Murai S, et al. Diagnosis and prevalence of protein - energy wasting and its association with mortality in Japanese haemodialysis patients. Nephrology (Carlton). 2017;22(7):541-7. doi: 10.1111/nep.12814][Carrero J.J, Stenvinkel P, Cuppari L, et al. Etiology of the protein - energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr. 2013;23(2):77-90. doi: 10.1053/j.jrn.2013.01.001]