title: Nutritional status of haemodialysis patients: comparison of Australian cohorts of Aboriginal and European descent.
abstract: OBJECTIVE
  It is not known whether nutritional status differs between Australian Aboriginal and non Aboriginal haemodialysis subjects. The aim of this study was to investigate the nutritional status of Australian Aboriginal and non-Aboriginal haemodialysis subjects at satellite dialysis centres.
  
  
  METHODS
  Seventy-six (25 Aboriginal, 51 non-Aboriginal) prevalent haemodialysis patients were enrolled in a 3-month cross-sectional study. Each month anthropometric and biochemical measurements were collected. Nutritional status (diet history, patient-generated subjective global assessment (PG-SGA), handgrip strength) was assessed by a dietitian.
  
  
  RESULTS
  PG-SGA detected mild to moderate malnutrition in 35% of Aboriginal patients and 25% of non-Aboriginal patients. The overall physical rating on the PG-SGA was significantly higher in Aboriginal patients, indicating the presence of a greater deficit in muscle mass in this population. Inter-dialytic weight gain was significantly greater in Aboriginal subjects (median [range] 3.0 [2.1-5.7] vs 2.5 [-0.3-5.0] kg, P<0.001). Glucose and HbA1c were significantly higher in Aboriginal subjects with diabetes than in non-Aboriginal patients with diabetes (median [range] 9.4 [4.9-23.4] vs 5.7 [3.1-12.9], P=0.002; 7.0 [5.2-11.0] vs 5.8 [4.6-9.0], P<0.000; respectively). These findings occurred in the setting of each cohort having adequate dialysis parameters (median Kt/V of >1.6 and median normalized protein catabolic rate 1.5). Difficulties were encountered in obtaining dietary information from Aboriginal subjects using the diet history method.
  
  
  CONCLUSIONS
  Subjects had acceptable parameters of dialysis adequacy; however, 35% had evidence of malnutrition. Further research should focus on establishing a knowledge base for the nutritional management for Aboriginal dialysis subjects, and the development of a validated individual dietary assessment method for use in this population group.
authors.affiliation: Department of Nutrition and Dietetics, Mater Health Services, Brisbane, Queensland, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; Department of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
authors.forename: Alwyn
authors.initials: A
authors.lastname: Todd
authors.forename: Robert
authors.initials: R
authors.lastname: Carroll
authors.forename: Meghan
authors.initials: M
authors.lastname: Gallagher
authors.forename: Anthony
authors.initials: A
authors.lastname: Meade
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009752:Nutritional Status; D006435:Renal Dialysis; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: nutrition assessment; population group; renal dialysis; serum albumin; water-electrolyte balance