Abstract
Protein-energy malnutrition are common in maintenance hemodialysis (MHD) patients and are associated with increased morbidity and mortality. To evaluate the nutritional status of Chinese MHD patients, we performed a cross-sectional study in unselected patients treated with hemodialysis thrice weekly. The subjects were MHD patients in our outpatient hemodialysis center. The physical measurement, laboratory values and three-day food diaries were collected. Body composition was measured by bioelectrical impedance analysis (BIA). Global nutritional status was evaluated by the modified quantitative subjective global assessment (MQSGA). 159 MHD patients (males 83, females 76, mean age 64.09±13.55 years, mean dialysis age 46.83±53.65 months) were enrolled. The mean body mass index (BMI) was 21.42±3.01kg/m2 in men and 20.35±2.73kg/m2 in women. The upper arm muscle circumference (23.72±2.75cm in men, 22.52±2.78cm in women) and hand-grip strength (26.23±9.61 in men, 17.16±7.76 in women) were lower than normal population standard values. By using BIA, the body fat mass percent (17.89±7.98 in men, 24.06±6.90 in women) was within the standard range of the normal population, but the body muscle mass percent (77.71±8.51 in men, 71.17±7.36 in women) was lower than the standard range of the normal population. Both the calorie intake (27.66±11.99kcal/kg) and protein intake (1.11±0.42g/kg) were lower than the K/DOQI guideline recommendation. The dietary sodium intake (2935.75±1495.50mg) was higher than K/DOQI guideline recommendation and the dietary phosphorus intake (903.25±300.38mg) was within the range of the K/DOQI guideline recommendation. The mean levels of serum albumin, serum phosphate and serum calcium were 39.34±3.12g/l, 1.76±0.62mmol/l and 2.35±0.26mmol/l, respectively. The mean level of MQSGA was 11.34±2.43. The total nutritional status of MHD patients in our hemodialysis center were not bad, except for body muscle mass and hand-grip strength. Despite the lower dietary calorie and protein intake, the nutritional status and normal serum phosphate level were maintained, which suggested the amount of dietary calorie and protein intake for Chinese MHD patients needs to be further investigated.
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