Relationship between the target dose for hemodialysis adequacy and nutritional assessment.

Abstract

BACKGROUNDSome studies have shown an increased relative risk of death for patients with higher levels of Kt/V, which may be associated with marked malnutrition.OBJECTIVEThe aim of this study was to investigate the relationship between the target dose for hemodialysis adequacy, as measured by Kt/V, and various nutritional parameters in hemodialysis patients.DESIGNCross-sectional.SETTINGSSakarya University Faculty of Medicine, Turkey between February 2014 and March 2014.PATIENTS AND METHODSFor consecutive patients who met criteria, the following were recorded: nutritional status, dialysis malnutrition score (DMS), the geriatric nutritional risk index (GNRI), serum albumin level, anthropometric measurements, and bioelectrical impedance analysis. Patients were classified into two groups according to the target hemodialysis dose for single-pool Kt/V: patients with spKt/V ≥1.4 and patients with spKt/V <1.4.MAIN OUTCOME MEASURE(S)Association of hemodialysis adequacy by nutritional assessment.RESULTSThe prevalence of malnutrition in 286 patients with target dose hemodialysis (spKt/V ≥ 1.4) was significantly higher according to body mass index (BMI), DMS, and GNRI (P=.001, P=.006, and P=.004, respectively) compared with patients with a lower target dose (spKt/V < 1.4). BMI, biceps skinfolds, mid-arm circumference, calf circumference, fat free mass, and total body water were statistically significantly lower in patients at a higher target dose (spKt/V ≥ 1.4) (P<.001, P=.034, P=.010, P<.001, P<.001, and P<.001 respectively).CONCLUSIONSMalnutrition was more frequent in chronic hemodialysis patients who received the target hemodialysis. Evaluation of nutritional status in patients at the target hemodialysis dose should be considered.LIMITATIONSData collected from a single region; small sample size; cross-sectional design is disadvantageous.