Protein intake in Indian haemodialysis patients.

OBJECTIVES: Aim of our study was to find out the amount of protein consumed by Indian haemodialysis patients. METHODS: Twenty patients with endstage renal disease on regular haemodialysis at a major urban dialysis centre in India had their Kt/V and nPCR measured monthly for 4 months utilising urea kinetic methods. RESULTS: Despite an adequate amount of dialysis per session being delivered to almost all of these patients (19 out of 20 had a Kt/V greater than 1.2) none of our patients had an nPCR greater than 1 gm/kg/day and only 4 patients i.e. 20% had a protein intake greater than 0.8 gm/kg/day which is a cut off point below which mortality has been shown to increase dramatically. Most of the patients had a protein intake between 0.7-0.8 gm/kg/day which is alarmingly low. Patients who consumed non vegetarian food at least thrice a week did appear to have a significantly higher protein intake compared to the rest of the patients. CONCLUSION: We believe that these results are likely to be representative of other dialysis centers in India and that an intensive effort at dietary education aimed at increasing the protein intake in our haemodialysis patients is urgently required. The morbidity and mortality of dialysis patients is high and perhaps appropriate dietary intervention can help to reduce this.

Evaluation of the efficacy and safety of azathioprine (Azoran), in fresh cases of renal homotransplantation.

In a randomised, controlled study, the efficacy and safety of an indigenously developed azathioprine formulation, Azoran/1000 (Searle), was compared with an imported formulation Imuran, as an immunosuppressive agent in fresh cases of renal transplantation. All 14 patients enrolled into the trial completed the study period were analysed. There were 8 episodes of rejection, 4 in each group. All these cases responded to pulse steroids. There was no instance of severe bone marrow suppression or hepatitis in either group and none of the patients had any drug related adverse effects. The results of this study show that Azoran is equiefficacious and safe as an immunosuppressive drug in renal transplants and compares satisfactorily in all respects with the imported formulation Imuran and has the added advantage of being easily available and less costly.