Gastrointestinal Symptoms and Nutritional Status in Women and Men on Maintenance Hemodialysis

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• 作者：Luciana Ferreira Silva ; RD ; MS ; PhD^&lowast ; ; ^&dagger ; ; ^&Dagger ; ; Gildete Barreto Lopes ; RN ; MS^&lowast ; ; Cá ; cia Mendes Matos ; MD ; MS^&lowast ; ; ^&Dagger ; ; Katherine Quadros Brito ; MD ; MS^&Dagger ; ; Maurí ; cio Kauark Amoedo ; MD^§ ; ; Matheus Freitas Azevedo ; MD^¶ ; ; Meiry Jane Sá ; Araú ; jo ; RD^&lowast ; &lowast ; ; ^&dagger ; &dagger ; ; Má ; rcia Silva Martins ; MD ; MS^&lowast ; ; ^&lowast ; &lowast ; ; Antonio Alberto Lopes ; MD ; MPH ; PhD^&lowast ; ; ^&Dagger ; &Dagger ; ; ^{aaslopes@ufba.br}
• 刊名：Journal of Renal Nutrition
• 出版年：2012
• 期刊代码：pca236_10512276
• 类别：med
• 出版时间：May, 2012
• 卷：22
• 期：3
• 页码：327-335
• 文件大小：119 K

摘要

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Objective

The main objective was to investigate whether the prevalences of nausea, vomiting, diarrhea, and reduced appetite varied by gender in maintenance hemodialysis (MHD) patients. We also evaluated whether these symptoms explain female-male difference in nutritional status.

Design

Cross section of baseline data of the Prospective Study of the Prognosis in Chronic Hemodialysis Patients.

Setting

Dialysis units in the city of Salvador, Brazil.

Patients

Three hundred ninety-seven men and 287 women with more than three months on MHD.

Predictor Variable

Gender.

Outcome Measures

The patient鈥檚 self-reported nausea, vomiting, diarrhea, and reduced appetite. The malnutrition-inflammation score (MIS) was used to assess nutritional status.

Results

The prevalence of symptoms was 24.3%for reduced appetite, 19.7%for nausea, 12.3%for vomiting, and 3.5%for diarrhea. In a logistic regression model with adjustments for age, diabetes, congestive heart failure, hemoglobin, albumin, Kt/V, and years on dialysis, women were found to have significantly higher odds of reduced appetite (odds ratio [OR] = 1.97), nausea (OR = 1.90), and vomiting (OR = 2.21). MIS was 5.41 卤 3.18 for women and 4.66 卤 3.28 for men (P = .002) corresponding to a percentage difference of 13.86%. The female-male difference reduced by more than half after excluding the gastrointestinal symptoms component and by approximately 65%after excluding both the gastrointestinal symptoms and the dietary intake components from the MIS.

Conclusions

The results suggest that the prevalences of nausea, vomiting, and reduced appetite are higher in women than in men on MHD. These gastrointestinal symptoms and perhaps their detrimental effects on dietary intake may partially explain a poorer nutritional status in MHD women.