title: Nutritional status and clinical outcome of uremic patients after high doses of hemodialysis.
abstract: The effects of high doses of hemodialysis on the nutritional status, morbidity and mortality of 85 metabolically stable chronic hemodialysis patients were studied. Urea kinetic studies showed Kt/Vurea 1.8 +/- 0.4, mean time-average concentration of urea (TAC) 48.4 +/- 11 mg/dL and protein catabolic rate (PCR) 1.3 +/- 0.3 g/kg/d. All patients were followed up over a 12-month period with blood biochemistry and anthropometry measurements. The total number of hospitalizations and mortality were also recorded. Study results showed positive correlations between PCR and Kt/V, and PCR and TAC. Age was negatively correlated with serum albumin. A PCR < 1.0 g/kg/d (n = 14) was highly associated with more hospital admissions than those with a PCR > or = 1.0 g/kg/d (n = 71). There was no significant difference in biochemical nutritional indices and urea kinetic study between diabetic patients and non-diabetic patients, while aged patients (> or = 65 years) had significant lower serum albumin and hematocrit. A significant number of patients had anthropometric measurements below the 10th percentile, when compared with the standard for the Taiwan area. No difference was found in the effect of diabetes mellitus and time on hemodialysis on the anthropometric variables. The mortality rate was 4.7% (4/85), and all deaths involved patients over 65 years of age with either diabetic nephropathy or diffuse vascular disease. Despite high doses of dialysis, there was a high prevalence of subclinical malnutrition evidenced by anthropometric measurements. However, high doses of dialysis improved protein intake, nutritional status, as well as morbidity and mortality. Younger patients (< 65 years) had excellent results in this short-term study.
authors.affiliation: Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, R.O.C.
authors.forename: C S
authors.initials: CS
authors.lastname: Yang
authors.forename: S J
authors.initials: SJ
authors.lastname: Chen
authors.forename: S W
authors.initials: SW
authors.lastname: Leu
authors.forename: P J
authors.initials: PJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D006435:Renal Dialysis; D014511:Uremia / Q000378:metabolism / Q000628:therapy*