Protein Energy Wasting Analysis Of Maintenance Hemodialysis Patients At Different Ages

ObjectiveTo investigate protein wasting and energy reserve in chronic renal failure (CRF) patients undergoing maintaining hemodialysis (HD) at different ages.MethodsA total of129HD patients (62men and67women) aged56.33±14.14years were involved in this study. They were divided into four groups:below40,40-69,60-69and over70years. Nutritional status was assessed by body mass index (BMI), normalized protein catabolic rate (nPCR) and biochemical parameters including albumin, pre-albumin and cholesterol. Body composition was tested with multi-frequency bioelectric impedance analysis,83healthy subjects, matched for age and sex, were as controls.ResultsBMI showed no significant difference between healthy controls and HD patients. Among HD patients,38%had a BMI higher than the normal high limit and6.2%had a BMI less than18.5kg/m2. Patients with low body weight accounted for0%,6.2%,4.8%, and11.1%respectively in the group<40years old,40～59years,60～69years and above70years. NPCR and prealbumin in the patients above70years were1.46±0.28g/kg.d and272.65±79.78mg/1, which were significantly lower than that in the40-59years group1.54±0.28g/kg.d, P=0.004and332.07±73.03mg/1, P=0.026. Body cell mass in HD patients was significantly lower than that in the control one22.81±8.12kg vs.29.95±6.73kg, P<0.001. Furthermore, compared with the control groups, the lean tissue mass (LTM)40.16±1.90kg vs.47.22±9.84kg and fat17.45±8.83kg vs.13.66±7.28kg were also significantly lower (both P=0.001) in these two groups. The lean tissue indicators in the group<40years old were also significantly lower than those in the healthy controls, P=0.012. For the fat tissue ingredients, the patitients<40years (P=0.013) and over70years (P=0.039) showed significant differences with the controls, while the60-69years groupshowed no such difference, P=0.191. ConclusionsNutritional status was different among HD patients at different ages. HD patients with age below40years and above70years were more susceptible to protein energy wasting. Although BMI showed no difference with the normal subjects, protein wasting and increased fat tissue storage existed in HD patients. The nutrition changes are slightest in patients40-59years old and much significant in over70years old.