A Study of the Nutritional Status and its Related Factors in the Elderly Hemodialysis Patients

ABSTRACT

The purpose of this study was to evaluate the nutritional status and to identify related factors in elderly hemodialysis patients. Sixty-four patients who were registered in Asan Medical Center, Seoul, Korea, participated in the study. The data was collected between September and December, 2003. General characteristics were obtained with the use of an interviewer-administered questionnaire. Anthropometric and biochemical data, 3-day dietary records and dietary habits were also obtained. The results of this study were analyzed with t-test or x2-test using SPSS package program. The percentage of elderly hemodialysis patients who were undergoing mild to severe malnutrition (MN group)and were normal nutrition (NN group) by subjective global assessment (SGA) criteria were 46.9% and 53.1%, respectively. Appetite (p<0.05) and dietary cholesterol intakes (p<0.05) were significantly lower in MN group than the NN group. Body mass index (BMI, p<0.001), lean body mass (LBM, p<0.05), triceps skinfold thickness (TSF, p<0.01), mid arm circumference (MAC, p<0.01)and mid arm muscle circumference (MAMC, p<0.05) were also lower in the MN group than the NN group. There were also significant differences in blood urea nitrogen (BUN, p<0.05), creatinine (p<0.05) , prealbumin (p<0.001) and C-reactive protein (CRP, p<0.05) . SGA was negatively correlated with serum BUN, creatinine and prealbumin, dry weight, BMI, LBM, total body water, TSF, MAC and MAMC, and positively correlated with age. In stepwise multiple regression analysis, SGA was related to BMI, CRP, age and BUN. In conclusion, almost half of the subjects were in malnourished status and had lower values in anthropometric and biochemical data. Our results suggest that SGA is a simple and adequate method for assessing the nutritional status in elderly hemodialysis patients and adequate dietary guidelines based on individual nutritional status are needed in the patients.