Desenvolvimento de produto alimentício para pacientes em tratamento crônico de hemodiálise

Abstract

Chronic kidney disease (CKD) is characterized by the presence of abnormalities in the structure and / or function of the kidneys present for more than three months, with complications to health. CKD is recognized as a public health problem that leads to a significant increase in mortality rates and presents high comorbidity related to cardiovascular diseases, hypertension, anemia, susceptibility to infection, type B and C hepatitis, renal osteodystrophy, protein energy wasting (PEW) and others comorbidities with lower frequency. Although the dialysis techniques (hemodialysis (HD) and peritoneal dialysis (PD)) have advanced since it was developed, the number of comorbidities with adverse effects on quality of life and mortality rates is still high. Among them, PEW stands out for its high prevalence among dialysis patients, especially among those in HD. Therefore, avoiding the development of PEW as well as seeking strategies for its treatment become important. Thus, the objective of this study was to elaborate food products for patients with CKD in HD treatment. To support the definition of the characteristics of food products, a food preference questionnaire was carried out using a tool developed for this purpose, which was applied in 183 adult patients (age ≥ 18 years) on HD treatment for at least three months in a dialysis clinic in the municipality of Duque de Caxias. The results obtained from the food preference questionnaire showed preference for salty food products with solid consistency. Therefore, a mini-cake flavored with herbals was chosen as the base formulation (FBase). From this FBase were developed two mini-cakes with distinct protein bases (whey protein WP and textured soy protein - TSP). After the development of the products, physical-chemical and microbiological analyzes were carried out. All statistical tests were performed using the Statistical Package for the Social Sciences (SSPS) - version 21 (Inc., Chicago, IL, USA). The food products developed showed high energy and protein content (206 to 208 kcal and 10,8 to 14,5 g protein in one portion of 60 g), and reduced content of phosphorus (48,9 to 49,6 mg), potassium (107,9 to 225,2 mg) and sodium (183,2 to 183,4 g). Microbiological analysis showed that all microorganisms analyzed were below the maximum values allowed by the legislation in all formulations. For the sensory analysis of the products, 60 patients from two dialysis units located in the cities of Rio de Janeiro and Niteroi and with the same eligibility criteria above were selected, in addition to presenting nutritional risk or PEW, were included. The sensorial analysis allowed to evaluate the acceptance and the intention of consumption of the mini-cakes. The two formulations of protein-modified mini-cakes had an acceptability index of more than 70% in all attributes assessed and intention to consume more than four points by the majority of patients