Use of 24-hour recall and protein nitrogen appearance for estimate of protein intake in patients on dialysis

Abstract

Introduction: Chronic kidney disease is a progressive, irreversible condition that compromises the nutritional status of patients due to multiple morbidities. In the final phase of the disease, which is characterized by dialytic treatment, the monitoring of dietary intake can help minimize complications in terms of nutritional status. Objectives: To investigate protein intake using the 24-hour recall method and protein nitrogen appearance (PNA) method in patients undergoing dialysis. Methods: A case series study was conducted with adult patients on hemodialysis for at least six months at a university hospital in Northeast Brazil. Nutritional status and dietary intake were assessed using the PNA method and 24-hour recall. Results: Average protein intake per gram per kilogram of weight analyzed by the PNA in both sexes was below the nutritional recommendations proposed for patients undergoing regular dialysis (1.2 g/kg/day). In contrast, intake was closer to the recommended value in men and women when the 24-hour recall was considered. No agreement was found between the PNA and 24-hour recall methods in the population studied. Discussion: The present investigation showed that average protein intake per gram per kilogram of weight analyzed using the PNA in both sexes was below the nutritional recommendations proposed for patients on dialysis. The same did not occur when using the 24-hour recall method. Conclusions: In nutritional follow-up without the possibility of measuring protein intake through predictive methods, dietary inquiries should be maintained as complementary to the nutritional assessment. Periodic nutritional follow-up can minimize adverse clinical and dietary outcomes in patients with chronic kidney disease, especially in the dialytic phase.