Analysis Of Nutritional Status And Related Factors In Maintenance Hemodialysis Patients

OBJECTS1Comprehensive to investigate the nutritional status of maintenance hemodialysis patients2To investigate the relationship between the nutritional assessment methods and the biochemical indicators.3To analyze the risk factors associated with malnutrition.METHODS98patients with end-stage renal on maintenance hemodialysis for at least3months blood purification center in the Second Hospital of Shandong University from August2009to February2010were recruited。 Nutritional Status questionnaire was used to assess the nutritional status of the patients. Demographics and clinical characteristics were recorded.1Modified Quantitative Subjective Global Assessment The Modified Quantitative Subjective Global Assessment (MQSGA) was used to comprehensive assessment of the nutritional status of dialysis patients.2Biochemical tests：fasting serum creatinine, urea nitrogen, albumin, pre-albumin, triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein and Hypersensitive C-reactive Protein were detected predialysis and serum creatinine, urea nitrogen were detected after dialysis. Hemodialylis Adequacy was assessed by Kt/V. Kt/V=-In(R-0.008×t)+(4-3.5×R)×UF/W, R:(BUN after-dialysis)/(BUN pre-dialysis); t:time of one hemolysis(h), UF:ultrafiltrition(L); W:bodyweight after-dialysis(kg), Hemodialylis Adequacy Kt/V≥1.2, Hemodialylis inadequacy Kt/V<1.2。 3Human body dimensions:body mass index, arm circumference, arm muscle circumference, triceps skinfold thickness.4Dietary survey:Dietary survey the food intake of the participants was recorded for3days by24-hour recall.RESULTS1The incidence of malnutrition:malnutrition in hemodialysis patients was48.9%according to MQSGA. There is a lower incidence of malnutrition in patients with Kt/V≥1.2than with Kt/V<1.2, creatinine between the two groups were statistically different.(P<0.05). The incidence of malnutrition was higher in the elder patients (75%) than in the young patients(36.3%), the nutritional indicators such as pre-albumin, creatinine between the two groups were statistically different.(P<0.01)2The Dietary survey:The Dietary survey showed that the actual standard body mass daily energy intake(DEI) was(28.15±10.98)k/(kg-d), the actual standard body mass daily protein intake(DPI) was (1.02±0.42)g/kg-d, and superior quality protein intake was (19.8±12.9)g/d. The DEI, DPI and superior quality protein intake of hemodialysis patients were much lower than the recommended standard.CONCLUSIONS1The incidence of malnutrition in hemodialysis patients was approximately50%.2Age was an independent risk factor of malnutrition in hemodialysis patients. The nutritional status of the eldly was much poorer than the young, much more attention should be paid to the eldly in the clinical practice.3There was a close relationship between Kt/V and the nutritional status in hemodialysis patients.4Inadequate intake of protein and energy was a major factor leading to malnutrition.