Appetite in Chronic Hemodialysis Patients: A Longitudinal Study

Objective

In hemodialysis (HD) patients, appetite behavior over time and the causes of diminished appetite are essentially unknown. The present study aimed to assess appetite over time in HD patients, and to define the factors associated with different appetite trends.

Design

We conducted a longitudinal study.

Setting

This study took place at the Hemodialysis Service of the Catholic University of the Sacred Heart of Rome, Italy.

Patients

We studied 54 HD prevalent patients.

Intervention

At baseline and 5 months later, we assessed appetite, nutritional and inflammatory parameters, comorbid conditions, and scores on the Charlson Comorbidity Index.

Main Outcome Measure

We were primarily interested in an evaluation of appetite over time and the definition of factors associated with different appetite trends.

Results

We identified 5 groups of patients. In group A (15 patients), every month, each patient responded that appetite was very good or good. In group B (10 patients), every month, each patient responded that appetite was good or fair. In group C (6 patients), every month, each patient responded that appetite was fair or poor. In group D (6 patients), every month, each patient responded that appetite was poor or very poor. In group E (17 patients), the answers of each patient varied over time. Groups A and B were pooled into group 1, groups C and D into group 2, and group E constituted group 3. Age was significantly lower in group 1 than in groups 2 and 3. Comorbidities were significantly more frequent in groups 2 and 3 than in group 1. The Charlson Comorbidity Index was significantly higher in groups 2 and 3 than in group 1. The percentage of patients hospitalized during follow-up and the number of hospitalizations were significantly higher in groups 2 and 3 than in group 1.

Conclusions

Appetite in HD patients may be constantly very good/good or fair/poor, or may fluctuate over time. The latter trends are associated with older age, more comorbidities, and more hospitalizations.