PD406 - PROTEIN-ENERGY WASTING IN HAEMODIALYSIS (HD): ASSOCIATION BETWEEN HYPOPHAGIA, METABOLIC-NUTRITIONAL STATUS, BODY COMPOSITION, AND CLINICAL OUTCOMES

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PD406

PROTEIN-ENERGY WASTING IN HAEMODIALYSIS (HD): ASSOCIATION BETWEEN HYPOPHAGIA, METABOLIC-NUTRITIONAL STATUS, BODY COMPOSITION, AND CLINICAL OUTCOMES

E. Assanto1, S. Rotondi1, G. Imbimbo1,*, C. Gallicchio1, F. Tambaro1, L. Tartaglione2, G. Zazza1, S. Lai1, S. Mazzaferro3, M. Muscaritoli1, A. Molfino1

1Department of Translational and Precision Medicine, Sapienza University of Rome, 2Department of Internal Medicine and Medical Specialties, AOU Policlinico Umberto I, 3Dialysis Unit, American Hospital, Rome, Italy

 

Rationale: Protein-Energy Wasting (PEW) in HD has a negative impact on quality of life and outcomes. This study analyzed the associations between PEW, hypophagia, and changes in body composition and their impact on hospitalization and mortality at 12 and 24-month follow-up.

Methods: We enrolled adult patients on HD at a single center in the years 2020-2021. Body composition was assessed by BIA. Energy-protein intake was calculated using 3-day food diaries. Hypophagia was defined as an energy intake <30 kcal/kg/day and/or a protein intake <1.2 g/kg/day. Hospitalization and mortality were registered.

Results: 75 patients were included and 26 (35%) were diagnosed with PEW. Patients with PEW showed lower values of phase angle (p = 0.039), fat-free mass index (FFMI; p < 0.001), ICW/height² (ICW/H² p < 0.001) and fat mass index (FMI; p < 0.001) compared with those without PEW; 47 patients (63%) met the criteria for hypophagia and exhibited lower FFMI (p= 0.004), FMI (p = 0.005), BMI (p = 0.004), and ICW/H² (p = 0.005) compared with those with no hypophagia. In logistic regression analysis, FMI [OR 0.54 (0.33–0.87), p = 0.011], energy intake (DEI) [OR 1.00 (0.99–1.00), p = 0.039], and normalized protein catabolic rate (nPCR) [OR 0.00 (0.00–0.21), p = 0.014] emerged as independent predictors of PEW. Although no differences in hospitalization or mortality were observed according to PEW and/or hypophagia, 70% of patients who experienced at least one hospitalization and 58% of those who died had either PEW or hypophagia.

Conclusion: In HD patients, PEW and hypophagia are prevalent and are associated with changes in body composition. DEI, FMI and nPCR emerged as determinants of PEW. Assessment of dietary intake, together with body composition analysis, is essential to identify patients at risk of PEW or already malnourished and to guide metabolic–nutritional interventions.

Disclosure of Interest: None declared