Biochemical Assessment of Malnutrition in Sudanese Patients with Chronic Renal Failure on Hemodialysis Maintenance Therapy
Mohammed Siddig Mulah *
Department of Medical Laboratory, Collage of Medical Technology, University of AL-Jufra, Libya.
Omer Fadul Idres
Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, Al -Neelain University, Sudan.
Salah Awad
Federal Minstry of Health, Pathology Laboratory Department, Ibn-sena Specialised Hospital, Khartoum, Sudan.
Abd Elkarim A. Abdrabo
Department of Clinical Chemistry, Faculty of Medical Laboratory Science, Al -Neelain University, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background: Malnutrition in Chronic Kidney Disease Patients on Hemodialysis remains one of the major causes of morbidity and mortality characterized by changes in circulating levels of plasma albumin, pre-albumin and transferrin.
Purpose: The aim of this study was to determine the serum levels of albumin, pre-albumin, transferrin, highly sensitive C-reactive protein (hs-CRP) and BMI as markers for malnutrition.
Materials and Methods: A total of one hundred patients with Chronic Kidney Disease on hemodialysis maintenance therapy and one hundred sex and age-matched healthy control subjects were enrolled in this study; After informed consent six milliliters of venous blood Were collected from each patient of the study group and the control group after dialysis session in the morning, after an overnight fasting in a plain container from which serum is separated and then stored in Eppendorf tubes at -80°C.
Results: In our study: significant decrease in the mean level of serum albumin (3.12±0.39) (P. value >0.001), pre-albumin (24.76±6.46) (P. value >0.001), transferrin (278.66±59.47) (P. value 0. 04), hs-CRP (20.13±5.70) (P. value >0.001) and BMI (20.3±5.5) (P. value >0.001) among the Chronic Kidney Disease patients on maintenance hemodialysis therapy when compared to the control group.
Furthermore, the results showed that there was a negative correlation between serum highly sensitive C-reactive protein with plasma albumin (rho= -.812, p<0.02), pre-albumin (rho= -0.752, p<0.02) and no correlation between serum hs-CRP with transferrin level (rho= -0.062, p=0.385).
Conclusion: In conclusion, a significant decreased in the mean level of serum albumin, pre-albumin, transferrin and BMI among Sudanese Patients with Chronic Kidney Disease on hemodialysis maintenance therapy place them at risk of developing Malnutrition.
The significant negative correlation between albumin and pre-albumin with hs-CRP proofed that Albumin and pre-albumin were negative acute phase reactants that tended to decreased during inflammation and these negative correlations linked between chronic systemic inflammation and malnutrition in chronic kidney disease patients on hemodialysis maintenance therapy.
Keywords: Chronic kidney disease (CKD), hemodialysis (HD), protein–energy malnutrition (PEM), body mass index (BMI)