Patients receiving maintenance hemodialysis with low vs high levels of nutritional risk have decreased morbidity.
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.
Burrowes
Jerrilynn D
JD
Department of Nutrition, C.W. Post Campus of Long Island University, Brooksville, NY 11548, USA. Jerrilynn.burrowes@liu.edu
Dalton
Sharron
S
Backstrand
Jeffrey
J
Levin
Nathan W
NW
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
D012709:Serum Albumin; D002784:Cholesterol; D003404:Creatinine