Relationship between dietary protein intake and nutritional status in maintenance hemodialysis patients

Abstract

Objective To assess the influence of protein intake on nutritional status and mineral metabolism in patients with maintenance hemodialysis (MHD). Methods A cross-sectional study and a prospective cohort study were conducted. According to dietary protein intake (DPI), patients were divided into two groups: DPI≥1.2 g·kg-1·d-1 group (HP group) and DPI<1.2 g·kg-1·d-1 group (NP group). One hundred and twenty-six MHD patients were enrolled in the cross-sectional study and their datum of dietary intake, as well as laboratory examinations were recorded. In the prospective cohort study lasted 2 years, 32 MHD patients were enrolled, with their dietary and laboratory examinations being collected every 3 months, and somatometric measurements being recorded at the beginning and the end of the study. Results In the cross-sectional study, the average DPI of HP group was (1.36±0.14) g·kg-1·d-1 and the average DPI of NP group was (1.04±0.09) g·kg-1·d-1. Compared with patients in NP group, patients in HP group had higher DPI, daily energy intake (DEI), normalized protein equivalent of nitrogen appearance rate (nPNA) and serum phosphate, and lower carbon dioxide combining power (CO2CP) (all P 0.05). There was higher DPI, nPNA and serum phosphate, and lower CO2CP in HP group, than those in NP group (all Pgroup 0.05). Conclusions DPI around 1.05 g·kg-1·d-1 can satisfy the nutritional requirement in MHD patients with good nutrional status, and ameliorate hyperphosphatemia and acidosis. Key words: Renal dialysis; Nutritional status; Hyperphosphatemia; Acidosis