Abstract
Malnutrition has been shown to be an important risk factor for increased mortality in the dialysis patients, and insufficient amino acid intake is one of the causes. Especially in Korea, the protein wasting would be more prevalent and severe because protein is relatively deficient in traditional Korean diet. We investigated the nutritional parameters of 72 hemodialysis (HD) patients(men : 35, women : 37) and 63 continuous ambulatory peritoneal dialysis (CAPD) patients (men : 30, women : 33) by measureing %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment), and by estimating energy and protein intakes with 1-month food frequency method. Between HD and CAPD group, mean age (55 ±12 vs. 56 ±12 yr), dialysis durations (45 ±31 vs. 41 ±24 mon), dietary energy intakes (28.3 ±9.0 vs. 28.8 ±8.6 kcal/kg/day), dietary protein intakes (1.1 ±0.3 vs. 1.0 ±0.5 g/kg/day) and incidence of co-morbid conditions (67.0% vs. 67.6%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (47.8%) than in HD patients (35.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. In conclusion, specialized nutrition education depending on dialytic modality should be necessary to efficiently improve nutritional status, and it can be postulated that essential amino acid and other supplement are helpful for improving nutritional status in dialysis patients, especially in peritoneal dialysis patients
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