title: Control of dry weight and tube feeding improved the general condition of a hemodialysis patient: report of a case.
abstract: Patients on long-term hemodialysis are at risk of developing malnutrition,and poor nutrient intake is an important factor in this. In the present case, we encountered a 55-year-old Japanese woman with end-stage renal failure and a past history of schizophrenia. Severe systemic edema was observed. Hemodialysis was started, but after one year she suddenly became unable to consume food orally, despite provision of a dietary plan by the nutrition support team (NST). Tube feeding was eventually implemented. Because the systemic edema did not improve, we decided to remove body fluid by intense hemodialysis. Hypotension was often observed during this hemodialysis, requiring dopamine. Over approximately 2 months, the patient's dry weight fell from 73 kg to 62 kg, the patient's activity improved and she became able to eat orally again, allowing tube feeding to be stopped. Although the reason for the sudden anorexia has not been clarified, tube feeding and dry weight control was successful in the treatment of this malnourished hemodialysis patient.
authors.affiliation: Department of Surgery, Kubokawa Hospital, Shimanto-cho, Kochi 786-0002, Japan. nakatanh@yahoo.co.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakatani
authors.forename: Hajime
authors.initials: H
authors.lastname: Shoji
authors.forename: Mari
authors.initials: M
authors.lastname: Shibata
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yuka
authors.initials: Y
authors.lastname: Tadokoro
authors.forename: Nozomi
authors.initials: N
authors.lastname: Ogura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hamada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawamura
mesh_terms: D000203:Activities of Daily Living; D004298:Dopamine / Q000627:therapeutic use; D004487:Edema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D044342:Malnutrition / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000009:adverse effects; D013566:Sympathomimetics / Q000627:therapeutic use; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D013566:Sympathomimetics; D004298:Dopamine