Nutritional status assessed from anthropometric measures in the HEMO study.
OBJECTIVE
Anthropometric methods are screening techniques for assessing nutritional stores of fat and lean tissues among persons with renal disease. This report presents cross-sectional baseline data on anthropometric indicators of nutritional status from a group of hemodialysis patients in a multicenter clinical trial, the Hemodialysis (HEMO) Study.


METHODS
The HEMO Study is a prospective, multicenter, randomized, 2 x 2 factorial clinical trial to evaluate the efficacy of the delivered dose of dialysis, defined by Kt/V, and membrane flux in reducing morbidity and mortality in (maintenance) hemodialysis patients. Standardized measures of weight, stature, body mass index (BMI), arm and calf circumference, and triceps and subscapular skinfolds were taken immediately after dialysis. The analytic methods consisted of univariate statistics, including means, standard deviations, and selected percentiles presented as tables of descriptive statistics. Study findings were compared with corresponding national reference data from the Second National Health and Nutrition Examination Survey (NHANES II).


METHODS
Eligible patients between 18 and 80 years of age on chronic hemodialysis for at least 3 months, receiving hemodialysis 3 times per week and with a residual renal clearance of < 1.5 mL/min were examined. Patients also had to be able to attain an eKt/V of > or = 1.45 in 4.5 hours or an anthropometric volume < 45 to 50 L thus excluding persons with body weights over about 85 kg. The study sample consisted of the first 1,000 randomized patients, 464 men and 536 women; 642 blacks, 318 whites; and 40 of other racial backgrounds out of 1,847 randomized.


RESULTS
Differences in nutritional status by sex, race, duration of dialysis, and comorbid disease were found among these patients enrolled in the HEMO Study. In comparison with NHANES II, these hemodialysis patients were, on average, lighter with less adipose and muscle tissue than healthy persons of the same ages. These findings can be indicators of persons with chronic disease. Those with diabetes were overweight based on their BMI values.


CONCLUSIONS
These HEMO Study data provide a clinical reference for the use of these anthropometric indicators in assessing the nutritional status of contemporary hemodialysis patients weighing < 85 kg.
Chumlea
Wm Cameron
WC
Department of Community Health, Wright State University, S.O.M., Lifespan Health Research Center, Kettering, OH 45420, USA. cameron.chumlea@wright.edu
Dwyer
Johanna
J
Bergen
Carol
C
Burkart
John
J
Paranandi
Lata
L
Frydrych
Anne
A
Cockram
David B
DB
Kusek
John W
JW
McLeroy
Sandra
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D044383:Black People; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D011446:Prospective Studies; D012016:Reference Values; D006435:Renal Dialysis; D013997:Time Factors; D014481:United States; D044465:White People; D001741:Black or African American