Densidad mineral ósea y adecuación de la dieta en pacientes con enfermedad renal crónica en hemodiálisis

Abstract

BACKGROUND: In chronic kidney disease (CKD) patients, malnutrition is common with loss of muscle mass and decreased bone mineral density (BMD), increasing the risk of morbidity. OBJECTIVE: To compare body composition, bone mineral density (BMD) and bone mineral content (BMC) between CKD patients and healthy subjects, and relate these parameters with energy, macronutrients and micronutrients intake. METHODS: Body composition was assessed 30 haemodialysis patients and compared with 28 healthy volunteers with DEXA. In patients, three 24 hours records of dietary intake were filled. RESULTS: A significantly lower BMD (p < 0.01) and BMC (p < 0.0) were found in CKD patients. There was a trend for patients to have lower fat free mass (FFM) than controls (p = 0.06). In men, differences in BMD and BMC lost significance when adjusting for fat mass FM (%) and FFM (kg). In CKD, 34.5% and 27.6% of patients had an adequate intake of energy and protein, respectively. However, it was observed a deficit of energy and protein intake in 31.0% and 44.8% of patients, respectively. No significant correlation was found in CKD patients between macronutrient and calcium intake and BMD or BMC. CONCLUSIONS: CKD have lower BMD and BMC than healthy volunteers. These differences lost significance in men, after adjusting for body composition parameters. A poor dietary adequacy was found in most patients with CKD, but no association was observed between these variables and body composition or bone mineral density.