Nutritional status and the role of diabetes mellitus in hemodialysis patients
2008
Cho, J.H. (Ewha Womans University, Seoul, Republic of Korea) | Hwang, J.Y. (Ewha Womans University, Seoul, Republic of Korea) | Lee, S.E. (Ewha Womans University, Seoul, Republic of Korea) | Jang, S.P. (Poog Sung Hemodialysis Clinic Center, Seoul, Republic of Korea) | Kim, W.Y. (Ewha Womans University, Seoul, Republic of Korea), E-mail: wykim@ewha.ac.kr
This study was aimed to investigate the nutritional status and the role of diabetes mellitus in hemodialysis (HD) patients. Anthropometric, biochemical, and dietary assessments for HD 110 patients (46 males and 64 females) were conducted. Mean body mass index (BMI) was 22.1 kg/㎡ and prevalence of underweight (BMI less than 18.5 kg/㎡) was 12%. The hypoalbuminemia (less than 3.5 g/dl) was found in 15.5% of the subject, and hypocholesterolemia (less than 150 mg/dl) in 46.4%. About half (50.9%) patients had anemia (hemoglobin: less than 11.0 g/dL). High prevalence of hyperphosphatemia (66.4%) and hyperkalemia (43.5%) was also observed. More than 60 percent of subjects were below the recommended intake levels of energy (30-35 kcal/kg IBW) and protein (1.2 g/kg IBW). The proportions of subjects taking less than estimated average requirements for calcium, vitamin B₁, vitamin B₂, vitamin C, and folate were more than 50%, whereas, about 20% of the subjects were above the recommended intake of phosphorus and potassium. Diabetes mellitus was the main cause of ESRD (45.5%). The diabetic ESRD patients showed higher HMI and less HD adequacy than nondiabetic patients. Diabetic patients also showed lower HDL-cholesterol levels. Diabetic ESRD patients had less energy from fat and a greater percentage of calories from carbohydrates. In conclusion, active nutrition monitoring is needed to improve the nutritional status of HD patients. A follow-up study is needed to document a causal relation between diabetes and its impact on morbidity and mortality in ESRD patients.
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