Nutrition and hemodialysis status of long-surviving hemodialysis patients.

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  • 長期血液透析患者の食生活の実態　　日本腎臓学会「血液透析患者の食事療法に関するガイドライン」との比較

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Abstract

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 hemodialysis 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-term survivors than in the control group, 1.10±0.16 and 0.99±0.17g/kg/day, respectively (p<0.05). Kt/V for urea was higher in long-term survivors, 1.63±0.22 vs. 1.39±0.25 (p<0.001), and Kt/V for β2-microglobulin was higher, 1.21±0.41 vs. 0.86±0.44 (p<0.001).<br>Body mass index of the long-term survivors was 20.0, 95% confidence interval (CI) was 19.1 to 20.9. Energy intake was 37.9 kcal/kg/day, 95% CI 35.3 to 40.7. 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 Nephrology, 1.45g/kg/day (95% CI 1.36 to 1.54, p<0.05), 1.73g/day (95% CI 1.57 to 1.90, p<0.01), 925mg/day (95% CI 840 to 1010, p<0.001), respectively. The actual intake of calcium was lower, 449mg/day (95% CI 373 to 525, p<0.001), while most patients used calcium carbonate as a phosphorus binder.<br>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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