Relationship between dialysis and nutritional adequacy in haemodialysis patients

Abstract

SUMMARY:The nutritional wellbeing and dialysis adequacy of 57 stable haemodialysis patients (34 males and 23 females) from two satellite dialysis centres were assessed. Nutritional and anthropometric assessment comprised a variety of serological, historical and somatic parameters. A previously validated urea monitor was used to assess dialysis dose (Kt/V) and normalized protein catabolic rate (nPCR). Over 70% were malnourished (19% severely), 60% had a nPCR < 1.2 g/kg per day, and 80% failed to reach an adequate energy intake. A close correlation was observed between the various measures of nutritional assessment. Almost half of the group (47%) demonstrated a Kt/V < 1.2, with a significantly higher level identified in females (1.3 ± 0.2 vs 1.0 ± 0.2, P < 0.05). This was in contrast to the nutritional data where there was an equal sex distribution. A close correlation was found between dialysis adequacy and the different nutritional and anthropometric parameters in subjects with a Kt/V < 1.2 (P < 0.01 to P < 0.001). Males appear to be at higher risk of malnutrition from inadequate dialysis, however, a higher than expected incidence of malnutrition was observed in both sexes who were adequately dialysed.