title: Patients receiving maintenance hemodialysis with low vs high levels of nutritional risk have decreased morbidity.
abstract: OBJECTIVE
  To compare the demographic and clinical characteristics and outcomes (morbidity) of 442 patients receiving maintenance hemodialysis who are at different levels of nutritional risk.
  
  
  METHODS
  A retrospective, longitudinal, chart review.
  
  
  METHODS
  An urban, outpatient hemodialysis unit in New York City. Subjects were stratified according to their number of nutritional risk factors: zero to one=low risk, two to three=moderate risk, four to six=high risk.
  
  
  METHODS
  Mean values for serum albumin <37 g/L, creatinine <884 micromol/L, total cholesterol <4.42 mmol/L, normalized protein nitrogen appearance <0.9 g/kg/day, weight change > -2.5 kg, and body mass index <24. Morbidity indicators were frequency and duration of hospitalizations.
  
  
  METHODS
  Descriptive statistics, analysis of variance, and chi 2 analysis were used to summarize data and to analyze mean differences between the groups and differences in categorical variables, respectively.
  
  
  RESULTS
  Compared with the high-risk group, the majority of subjects in the low-risk group were younger, male, and did not have diabetes; fewer had two or more comorbidities. The high-risk group had 75% more hospitalizations and spent 195% more days in the hospital than the low-risk group.
  
  
  CONCLUSIONS
  Declining values of the nutritional risk factors and higher hospitalization rates were present in the high-risk group. Older subjects, those with diabetes, and those with two or more comorbidities comprised the majority of the high-risk group. More aggressive nutrition counseling and interventions may be needed for high-risk group members to determine if their risk for morbidity could be reduced.
authors.affiliation: Department of Nutrition, C.W. Post Campus of Long Island University, Brooksville, NY 11548, USA. Jerrilynn.burrowes@liu.edu
authors.forename: Jerrilynn D
authors.initials: JD
authors.lastname: Burrowes
authors.forename: Sharron
authors.initials: S
authors.lastname: Dalton
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Backstrand
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
mesh_terms: D000367:Age Factors; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000704:Analysis of Variance; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000032:analysis; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009752:Nutritional Status; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D051437:Renal Insufficiency / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D012709:Serum Albumin; D002784:Cholesterol; D003404:Creatinine