Nutrition and hemodialysis status of long-surviving hemodialysis patients Hiroshi Watanabe*1, Yoshiko Okada*2, Masahiro Mori*1, Takashi*2, Hidehiro Ta
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1 Nutrition and hemodialysis status of long-surviving hemodialysis patients Hiroshi Watanabe*1, Yoshiko Okada*2, Masahiro Mori*1, Takashi*2, Hidehiro Tanji*2, Naohisa Ibuki*2, Yorimitsu Tatsukawa*2, Yoshihiko Taniauchi*3, Seiji Marubayashi*3,4, Toshimasa Asahara*3,4 Sanyo Jin Clinic*1; Sanyo Hospital*2; Department of Blood Purification, Hiroshima University School of Medicine*3; Department of Surgery U, Hiroshima University School of Medicine*4 Nutrition and hernodialysis status of twenty-two patients who had been on hemodialysis for 15 years or longer was examined in single center. These long-term survivors were compared to a control group of 50 hemoialysis patients matched for age, gender and causes of renal failure, who had been on hemodialysis for 2 to 10 years. Normalized protein catabolic rate was higher in the long-ter survivors than in the control group, and 0.99 }0.17g/kg/day, respectively (p<0.). Kt/V for urea was higher in long-term survivors, }0.22 vs }0.25 (p<0.1), and Kt/V for Ĉ2-microgloulin was higher, 1.21 }0.41 vs }0.44 (p< 0.001).
2 Body mass index of the long-term survivors was 20.0, 95% confidence interval (CI) was 19.1 to Energy intake was 37.9 kcal/kg/day, 95% CI 35.3 to The actual dietary intake of protein, potassium and phosphorus of the long-term survivors was higher than those recomende by the Guidelines of the Japan Society of phrology, 1.45g/kg/day (95% CI 1.36 to 154, p<005), 1.73 /day (95% CI 1.57 to 1.90, p< 0.01), 925mg/day (95% CI 840 t 1010, p<0.001), respectively. The actual intake of calcium was lower, 449 mg/day (95% CI 373 to 525, p<0.001), while most patients used calcium carbonate as a phosphorus binder. The characteristic dietary intake of the long-term survivors was higher in calories, higher in protein and lower in calcium with adequate dialysis and calcium-based phosphorus binder.
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5 3) Shinzato T, Nakai S, Fujita Y, Takai I, Morita H, Nakane K, Maeda K: Determination of Kt/V and protein catabolic rate using pre and postdialysis blood urea nitrogen concentrations. Nephron 67: , ) Locatelli F, Alberti D, Graziani G, Buccianti G, Redaelli B, Giangrande A, The Northern Italian Cooperative Study Group a Prospective, randomis ed, multicentre trial of effect of protein restriction on progression of chronic renal insufficiency. Lan cet 337: , ) Klahr S, Levey AS, Beck GJ, Caggiula A, Hun sicker L, Kusek JW, Striker G, The Modification of Diet in Renal Disuse Study Group e The effects of dietary protein restriction and bloodpressure con trol on the progression of chronic renal disease. N Engl J Med 330: , ) Aparicio M, Cano N, Chauveau P, Azar R, Canaud B, Flory A, Laville M, Leverve X, French Study Group for Nutrition in Dialysis o Nutritional status of hemodialysis patients. Nephrol Dial Transplant 14: , ) Kopple JD: National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis 37 (Suppl 2): S 66 70, ) Fleischmann EH, Bower JD, Salahudeen AK: Risk factor paradox in hemodialysis a better nutrition as a partial explanation. ASAIO J 47: 74-31, ) Ifudu O: Care of patients undergoing hemodialysis. N Engl J Med 339: , Comments discussion in: N Engl J Med 340: , ) Uribarri J a The obsession with high dietary protein intake in ESRD patients on dialysis: is it justified? Nephron 86: , ) Uribarri J: Protein catabolic rate may underesti mate dietary protein intake in heir udialysis and patients. Nephron 82: 97-99, ) Chazot C, Laurent G, Charra B, Blanc C, VOVan C, Jean G, Vanel T, Terrat JC, uffet M: Malnutri tion in long-term haemodialysis survivors. Nephrol Dial Transplant 16: 61-69, ) Gotch FA, Sargent JA, Keen ML: Whither goest Kt/V? Kidney Int 58 (Suppl 76): S 3-S 18, ) Clark WR, Henderson LW: Renal versus continu ous versus intermittent therapies for removal of uremic toxins. Kidney Int 59 (Suppl 78): S 298 S 303,
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