Dialysis and nutrition practices in Korean hemodialysis centers.
OBJECTIVE
Survey the dialysis practices and nutritional status-related patient characteristics.


METHODS
Cross-sectional survey.


METHODS
Twenty-eight randomly selected Korean hemodialysis facilities.


METHODS
Medical record review of 140 randomly selected patients in 28 Korean dialysis facilities. The Student t test and chi-square tests were used to compare facility types and locations.


RESULTS
The mean number of dialysis treatments per week was 2.7 +/- 0.4. Mean dialysis treatment length was 253 +/- 27.5 minutes. Rural dialysis centers reported fewer treatments per week and shorter dialysis treatment times than did urban centers but, otherwise, there were few differences by either location (urban v rural) or by facility type (hospital affiliated v freestanding facility). The mean age of the patients surveyed by record review was 51 +/- 14 years, and 59% of the patients were men. The primary causes of end-stage renal disease were chronic glomerulonephritis, hypertension, and diabetes. Average vintage of dialysis was 53 +/- 46 months. Adequacy of dialysis was usually assessed by using clinical judgment; urea kinetic modeling and urea reduction ratios were used less frequently. Patients' mean body mass index was 20.7 +/- 2.3, which was at the lower end of the healthy range of 18.5 to 25, and most (93%) of their weights had been stable over the previous 6 months. Their mean serum albumin level was 4.0 +/- 0.4 g/dL. Forty-two percent of patients used iron supplements and 68% of them received erythropoietin treatment. However, their mean hematocrit levels were only 25.9% +/- 4.2%, suggesting that iron supplements were underused or erythropoietin doses were lower than optimal. Virtually all patients (94%) had received initial diet instruction but few (6%) received follow-up nutrition counseling.


CONCLUSIONS
Greater attention to dialysis adequacy, hematocrit levels, nutrition assessment, weight monitoring, and diet therapy are recommended.
Han
Haewook
H
Division of Nephrology, New England Medical Center, Boston, MA 02111, USA. hhan@world.std.com
Bleyer
Anthony J
AJ
Houser
Robert F
RF
Jacques
Paul F
PF
Dwyer
Johanna T
JT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D001835:Body Weight; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D007723:Korea; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000009:adverse effects / Q000592:standards*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D011795:Surveys and Questionnaires; D013997:Time Factors
D012709:Serum Albumin; D004921:Erythropoietin; D007501:Iron