ABSTRACT
Malnutrition is a common problem in patients undergoing maintenance hemodialysis (HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in these patients. This study was conducted to evaluate the effectiveness of nutrition education at improving nutritional status of 23 Korean HD patients (mean : 48.6 +/- 10.4 years, men : 8, women : 15). Anthropometric indices, nutrient intakes, and biochemical blood indices were measured before and after a 6-month nutrition education intervention. Anthropometric indices such as percent ideal body weight [PIBW (%)], body fat, body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and calculated arm muscle area (CAMA) of subjects were within the normal range and not changed by nutrition education. Subjective global assessment (SGA) was significantly increased (p<0.05) after nutrition education. Intake of total energy, carbohydrate, lipid, Ca, and vitamin B1 was increased significantly (p<0.05) but intake of phosphorus, potassium, and sodium was decreased (p<0.05). The serum concentrations of albumin, total protein, and Ca were significantly increased (p<0.05), but levels of P and K were decreased (p<0.05) after the intervention. These findings suggest that nutrition education for HD patients can be effective for positively changing nutrient intakes, leading to improvements in blood indices and nutritional status.
Subject(s)
Female , Humans , Male , Adipose Tissue , Arm , Body Mass Index , Eating , Education , Ideal Body Weight , Malnutrition , Mortality , Nutritional Status , Phosphorus , Potassium , Reference Values , Renal Dialysis , Sodium , ThiamineABSTRACT
BACKGROUND: Dialysis patients as a group appear to have a caloric and a protein intake less than the recommended values; because their energy expenditure is not different from that of healthy adults and because amino acid loss and increased catabolism during dialysis they should be in negative caloric & nitrogen balance and lose body mass and protein such as albumin progressively. Recently, papers dissenting about recommended protein intake in DOQI guideline were published. Because Korean people had different body size and dietary pattern from white races, recommanded protein and calorie intake may be different from that of white races. METHODS: We retrospectively analyzed our data in a group of hemodialysis patients who had dietary evaluations and kinetic measurements performed two consecutive times over a period of 18 months. RESULTS: Body weight(55.22+/-.48 kg to 57.39+/-0.29 kg, p=0.008), LBM(lean body mass, 42.79+/-.49 kg to 46.09+/-.13 kg, p=0.000), BMI(Body Mass Index, 21.89+/-.21 kg/m2 to 22.75+/-.53 kg/m2, p=0.007) and serum albumin level(3.65+/-.47 g/dL vs 3.87+/-.42 g/dL, p=0.000) were increased compared to initial values. Fat mass, TSF(Triceps Skin Fold thickness), MAC(Mid-Arm Circumference), MAMC(Mid- Arm Muscle Circumference) were remained stable over this period of time. These results suggested that these patients are not in negative energy and nitrogen balance. CONCLUSION: Albumin and body weight remained stable over a period of 18 months in spite of 27.25+/-.39 kcal/kg calorie intakes and 1.03+/-.43 g/kg protein intakes. Recommanded protein and calorie intake of Korean people may be different from that of white races.
Subject(s)
Adult , Humans , Arm , Body Size , Body Weight , Racial Groups , Dialysis , Dissent and Disputes , Energy Metabolism , Follow-Up Studies , Metabolism , Nitrogen , Nutritional Status , Renal Dialysis , Retrospective Studies , Serum Albumin , SkinABSTRACT
It is well known that depression and sense of hopelessness worsen the quality of life in end-stage renal disease (ESRD) patients receiving dialysis. However, the characteristics of depression in continuous ambulatory peritoneal dialysis (CAPD) patients have not been analyzed in detail. We performed this study to investigate the severity of depression and the factors affecting depression in CAPD patients. With 96 CAPD patients, we evaluated each patient's depressive mood and hopelessness with CES-D (Center for Epidemiologic Studies Depression) scale and Beck Hopelessness Scale. We also evaluated the degree of stress of each patient with internal individual stress scale. Most CAPD patients experienced severe depression compared with the general population. Their depression was better explained by psychological factors, such as stress and sense of hopelessness, than by demographic or physical factors. On the basis of these findings, we suggest that the treatment of depression in CAPD patients might be possible by modulation of psychological factors.