title: Nutritional status in the HEMO Study cohort at baseline. Hemodialysis.
abstract: The nutritional status of the first 1,000 patients randomized into the Hemodialysis (HEMO) Study was analyzed at baseline when they received their typical dialysis dose (equilibrated Kt/V = 1.30 +/- 0.22) and dialysis membrane. This is the largest study to date of the nutritional status of chronic hemodialysis patients. The mean (+/- SD) values for these parameters included a serum albumin level of 3.65 +/- 0.38 g/dL, a dietary energy intake of 22.9 +/- 8.4 kcal/kg/day, a dietary protein intake of 0.93 +/- 0.36 g/kg/day, and a double pool normalized protein catabolic rate (enPCR) of 1.00 +/- 0.25 g/kg/day. The percentage of patients below HEMO Study nutritional standards of care included 29% of patients with a serum albumin level less than 3.5 g/dL, 76% of patients with a dietary energy intake less than 28 kcal/kg/day, 61% of patients with a dietary protein intake less than 1.0 g/kg/day, and 52% of patients with an enPCR of less than 1.0 g/kg/day. There was a strong correlation between dietary protein intake and dietary energy intake (r = 0.74, P < 0.0001). Significant correlations were also evident between serum albumin and double pool PCR and between dietary protein intake and double-pool PCR. Kt/V and membrane flux were not predictive of baseline dietary protein intake, dietary energy intake, or serum albumin level. Thus, a majority of patients in the HEMO Study had protein and energy intake levels and enPCR levels that were below National Kidney Foundation Kidney Dialysis Outcome Quality Improvement (NKF-K/DOQI) guidelines.
authors.affiliation: Wake Forest University School of Medicine, Department of Internal Medicine, Winston-Salem, NC 27157-1053, USA. mrocco@wfubmc.edu
authors.forename: Michael V
authors.initials: MV
authors.lastname: Rocco
authors.forename: Lata
authors.initials: L
authors.lastname: Paranandi
authors.forename: Jerrilynn D
authors.initials: JD
authors.lastname: Burrowes
authors.forename: David B
authors.initials: DB
authors.lastname: Cockram
authors.forename: Johanna T
authors.initials: JT
authors.lastname: Dwyer
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: June
authors.initials: J
authors.lastname: Leung
authors.forename: Rhoda
authors.initials: R
authors.lastname: Makoff
authors.forename: Bradley
authors.initials: B
authors.lastname: Maroni
authors.forename: Diane
authors.initials: D
authors.lastname: Poole
mesh_terms: D000368:Aged; D000886:Anthropometry; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D004435:Eating; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011897:Random Allocation; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D004044:Dietary Proteins; D012709:Serum Albumin