ABSTRACT
Objective To survey the nutritional status of maintenance hemodialysis (MHD) patients and explore the role of oral nutritional supplement (ONS) in improving nutritional status among MHD patients. Methods From January 2016 to December 2017, one hundred and sixty-two MHD patients were selected randomly from hemodialysis centre of No. 2 peoples’Hospital and assessed malnutrition incidence by objective score of nutrition on dialysis (OSND). Patients with malnutrition were divided into control group and ONS group randomly, patients in control group were conducted with traditional nutritional education, while patients in ONS group were conducted with ONS as a substitution of diet on the basis of control group. Finally, nutrition-related indexes were observed after 6 months. Results The malnutrition incidence of MHD patients was 66.7% (108/162) screening by OSND, the malnutrition incidence of patients over 60 years old was 82.8% (72/87), significantly higher than below 60 years old, 49.3%(37/75)(P<0.05). After 6-month intervention, the differences of nutrition-related physical and laboratory indexes between control group and ONS group was observed [BW:(53.2±6.5)kg vs. (50.7± 6.0)kg, t=2.08, P=0.04; TSF:(10.3±3.1)mm vs. (9.0±3.0)mm, t=2.21, P=0.03; ALB:(39.6±5.6)g/L vs. (35.6± 5.5)g/L, t=3.74, P<0.01; HB:(104.5±10.8)g/L vs. (99.7±12.6)g/L, t=2.13, P=0.04; TF:(2.0±0.5)g/L vs. (1.5± 0.4)g/L, t=5.74, P<0.01], while opposite before intervention (P>0.05). There was no significant difference of OSND, GNRI and MIS scores between control group and ONS group before intervention [OSND:(24.1± 1.9) vs. (25.3 ± 1.7), t=3.46, P<0.01; GRNI:(90.4 ± 5.4) vs. (92.4 ± 4.5), t=2.09, P=0.04; MIS:(9.2 ± 3.2) vs. (10.9±3.3), t=2.72, P=0.01], while opposite after intervention (P<0.05). Subjective feeling score of patients in ONS group was significantly higher than control group after intervention [(10.7±3.5)vs(8.9±4.0), t=2.49, P=0.01]. The extra cost in control group and ONS group was (688.8±254.6) RMB and (749.2±44.9) RMB respectively with no significance (t=1.72, P=0.09). Conclusion The malnutrition incidence is high among MHD patients, traditional nutrition education takes poor patients compliance, while ONS could improve patients′ compliance and nutritional status because of scientific formula and good taste, which provide another diet selection for MHD patients.
ABSTRACT
Objective@#To survey the nutritional status of maintenance hemodialysis (MHD) patients and explore the role of oral nutritional supplement (ONS) in improving nutritional status among MHD patients.@*Methods@#From January 2016 to December 2017, one hundred and sixty-two MHD patients were selected randomly from hemodialysis centre of No. 2 peoples’ Hospital and assessed malnutrition incidence by objective score of nutrition on dialysis (OSND). Patients with malnutrition were divided into control group and ONS group randomly, patients in control group were conducted with traditional nutritional education, while patients in ONS group were conducted with ONS as a substitution of diet on the basis of control group. Finally, nutrition-related indexes were observed after 6 months.@*Results@#The malnutrition incidence of MHD patients was 66.7% (108/162) screening by OSND, the malnutrition incidence of patients over 60 years old was 82.8% (72/87), significantly higher than below 60 years old, 49.3%(37/75)(P<0.05). After 6-month intervention, the differences of nutrition-related physical and laboratory indexes between control group and ONS group was observed [BW:(53.2±6.5)kg vs. (50.7±6.0)kg, t=2.08, P=0.04; TSF:(10.3±3.1)mm vs. (9.0±3.0)mm, t=2.21, P=0.03; ALB:(39.6±5.6)g/L vs. (35.6±5.5)g/L, t=3.74, P<0.01; HB:(104.5±10.8)g/L vs. (99.7±12.6)g/L, t=2.13, P=0.04; TF:(2.0±0.5)g/L vs. (1.5±0.4)g/L, t=5.74, P<0.01], while opposite before intervention (P>0.05). There was no significant difference of OSND, GNRI and MIS scores between control group and ONS group before intervention [OSND:(24.1±1.9) vs. (25.3±1.7), t=3.46, P<0.01; GRNI:(90.4±5.4) vs. (92.4±4.5), t=2.09, P=0.04; MIS:(9.2±3.2) vs. (10.9±3.3), t=2.72, P=0.01], while opposite after intervention (P<0.05). Subjective feeling score of patients in ONS group was significantly higher than control group after intervention [(10.7±3.5)vs(8.9±4.0), t=2.49, P=0.01]. The extra cost in control group and ONS group was (688.8±254.6) RMB and (749.2±44.9) RMB respectively with no significance (t=1.72, P=0.09).@*Conclusion@#The malnutrition incidence is high among MHD patients, traditional nutrition education takes poor patients compliance, while ONS could improve patients′ compliance and nutritional status because of scientific formula and good taste, which provide another diet selection for MHD patients.
ABSTRACT
Objective To evaluate the nutritional status in maintenance hemodialysis patients using objective score of nutrition on dialysis.Methods Patients on maintenance hemodialysis were randomly selected and divided into three groups based on objective score of nutrition on dialysis:normal nutritional status group,moderate nutritional status group,and low nutritional status group.Logistic regression analysis was performed to identify factors of malnutrition.Furthermore,the results were compared with those of subjective global assessment.Results Totally 75 patients(male:female =1.13∶1)with a mean age of(54.90 ± 12.10)years and a mean vintage of (85.37 ± 54.17)months were enrolled.As determined by objective score of nutrition on dialysis,15 patients (20％)were divided into normal nutritional status group,42(56％)into moderate nutritional status group,and 18(24％)into low nutritional status group.Compared with the normal nutritional status group,the low nutritional status group had significantly different body mass index[(19.81 ± 2.22)vs(23.90 ± 2.44)kg/m2,P =0.030]and dry weight[(50.85 ± 7.60)vs(59.94 ± 10.89)kg,P =0.020].In addition,compared with normal nutritional status group,the moderate nutritional status group and low nutritional status group had significantly different total cholesterol[(4.60 ± 0.84)and(3.73 ± 0.68)mmol/L vs(5.71 ± 1.64)mmol/L,P =0.011,P =0.000],normalized protein catabolic rate[1.17 and 1.15 g/(kg · d)vs 1.45 g/(kg · d),P =0.030,P =0.010],triceps skinfold thickness[(1.44±0.77)and(1.00±0.41)cmvs(1.80±0.63)cm,P=0.032,P=0.020],mid-ann circumference[(24.85±1.48)and(21.66±1.48)cmvs(24.99 ±2.30)cm,P=0.046,P =0.037].Logistic regression analysis indicated C-reactive protein(OR =12.482,95％ CI =0.190-130.928,P =0.035)and normalized protein catabolic rate(OR =0.128,95％ CI =0.022-0.736,P =0.021)were significantly correlated with malnutrition.Conclusion Malnutrition is common in hemodialysis patients,with inflammation and low protein intake being its independent factors.