Abstract
BackgroundNutritional factors are associated with high mortality and morbidity in dialysis patients, and protein-energy wasting is regarded as an important one. The modality of dialysis may affect patients’ dietary behavior and nutritional status, but no study has compared the dietary behavior, nutrient intake, and nutritional adequacy of hemodialysis (HD) and peritoneal dialysis (PD) patients.MethodsFrom December 2016 to May 2017, a dietary behavior survey and Semi-quantitative Food Frequency Questionnaire (Semi-FFQ) were conducted on 30 HD patients and 30 PD patients in Ewha Womans University Mokdong Hospital, and laboratory parameters were obtained. The results of prevalent HD and PD patients were then compared.ResultsThe mean age of HD patients was higher than that of PD patients; HD: 58.5 ± 9.1 years, PD: 49.3 ± 9.7 years (p = 0.001). In the dietary behavior survey, HD patients showed more appropriate dietary behavior patterns overall than PD patients. In the dietary intake analysis with the Semi-FFQ, energy intake was significantly lower in the PD group than in the HD group due to the lower intake of carbohydrates, fat, and protein. A comparison of nutrient intake-to-recommended allowance ratio between the HD and PD groups revealed that the HD group showed higher nutrient intake than the PD group. Serum albumin and potassium levels were significantly higher in HD than in PD patients.ConclusionAccording to this study, the dietary behavior and nutritional intake of prevalent PD patients were worse than those of HD patients.
Highlights
Nutritional factors are associated with high mortality and morbidity in dialysis patients, and proteinenergy wasting is regarded as an important one
A few studies have compared the nutritional status of HD and peritoneal dialysis (PD) patients [9,10,11], no study has assessed and compared nutrient intake by the Semi-quantitative Food Frequency Questionnaire (Semi-FFQ) and dietary behavior according to dialysis modality
We excluded patients who were younger than 18 years of age, had a plan for renal transplantation within 3 months, had a life expectancy of less than 3 months, had distinct edema observed by the investigators, acute disease phase leading to admission, hybrid dialysis type using both of hemodialysis and peritoneal dialysis, and cognitive impairments who are unable to complete questionnaires
Summary
Nutritional factors are associated with high mortality and morbidity in dialysis patients, and proteinenergy wasting is regarded as an important one. The modality of dialysis may affect patients’ dietary behavior and nutritional status, but no study has compared the dietary behavior, nutrient intake, and nutritional adequacy of hemodialysis (HD) and peritoneal dialysis (PD) patients. Among the factors associated with high mortality and morbidity in dialysis patients, proteinenergy wasting (PEW) is regarded as an important one. Residual renal function in patients with peritoneal dialysis increases small solute clearance and intake of actual dietary nutrients. Most PD patients are recommended a diet that is more liberal than that of HD patients [8] According to this dissimilarity in the nature of dialysis, dietary counseling usually differs for HD and PD
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