Influence Of Diet Intervention On Nutritional Status And Survival Quality Of MHD Patients

Part Ⅰ Investigation of nutritional status in MHD patientsObjective: To assess the nutritional status of the maintain hemodialysis(MHD)patients by bioelectric impedance analysis,anthropometry and biochemistry tests.Method:80 MHD patients were included,53 male and 27 female,average age was 52.70±14.72,average duration of dialysis was 68.96±45.12 months.nutritional status were investigated by bioelectric impedance analysis,anthropometry and biochemistry tests.Results:The daily energy intake of 80 MHD patients was 15.98-64.82 kcal/kg?d,average value was 32.89±9.69kcal/kg·d;protein intake was 0.38-2.63g/kg?d,average value was 1.08±0.42g/kg·d,in which male higher than female(1.16±0.45g/kg?d vs 0.94±0.32g/kg?d,P<0.05).The BMI of 80 MHD patients was 15.70-33.50kg/m2,average value was 22.66±3.81kg/m2,in which male higher than female(23.34±3.58kg/m2 vs 21.24±3.82kg/m2,P<0.05);The MAC of 80 MHD patients was 20.80-37.25 cm,average value was 28.37±3.77cm;The MAMC of 80 MHD patients was 9.45-30.20 cm,average value was 21.63±3.89cm;The TSF of 80 MHD patients was 10.50-28.25 mm,average value was 20.37±4.10mm;The Hb of 80 MHD patients was 64.10-147.50g/L,average value was 113.16±14.38g/L.The PAB of 60 MHD patients was 140.70-544.50mg/L,average value was 365.07±87.47 mg/L;The ALB of MHD patients was 32.00-47.70g/L,average value was 39.96±3.35 g/L.15.00% of MHD patients were malnutrition by the BMI standard;13.75% were malnutrition by the MAC standard;2.50% were malnutrition by the TSF standard;58.75% were malnutrition by the MAMC standard;3.33% were malnutrition by the PAB standard;48.33% were malnutrition by the ALB standard.There was significant correlation between skeletal muscle and ALB,(r=0.265,P<0.05),there was significant correlation between skeletal muscle and BMI,(r=0.410,P<0.05),there was significant correlation between body fat and BMI,(r=0.877,P<0.05),there was significant correlation between protein and ALB,(r=0.269,P<0.05),there was significant correlation between body fat and TSF,(r=0.507,P<0.05),there was significant correlation between skeletal muscle and MAMC,(r=0.411,P<0.05),there was significant correlation between skeletal muscle and PAB,(r=0.256,P<0.05).Conclusion:1 Malnutrition was found in maintain hemodialysis(MHD)patients.Different type of malnutrition was found in MHD patients by different index.2 Bioelectric impedance analysis had the advantages of inexpensive,easy operation and convenient for using,painless.There was significant correlation between BIA and anthropometry,and BIA had clinical reference value in the evaluation of nutritional status for MHD patients.Part Ⅱ Influence of diet intervention on Nutritional status and survival quality of MHD patientsObjective: To assess the nutritional status of the maintain hemodialysis(MHD)patients by bioelectric impedance analysis,anthropometry and biochemistry tests.And to evaluate the influence of diet intervention on nutritional status and survival quality of MHD patientsMethod:49 MHD patients were included,32 male and 17 female,average age was 50.18±14.61.Nutritional status were investigated by bioelectric impedance analysis,anthropometry and biochemistry tests.Survival quality was investigated by using the short-form 36 Health Survey Questionnaire(SF-36).Through formulating individualized recipe and promoting the knowledge of nutrition,49 MHD patients received diet intervention for 6 months.Their nutritional status and survival quality were assessed,respectively before and after the diet intervention.Results:The BMI of MHD patienys had significantly elevated after diet intervention(22.33±3.39 vs 22.69±3.37)(P<0.05),The MAC had significantly elevated after diet intervention(28.24±3.64 vs 26.52±3.29)(P<0.05),The MAMC had significantly elevated after diet intervention(21.55±3.86 vs 19.76±3.33)(P<0.05),The body fat had significantly elevated after diet intervention(16.81±6.77 vs 18.10±7.51)(P<0.05),The weight had significantly elevated after diet intervention(59.91±11.26 vs 61.14±11.43)(P<0.05),In which,The female body fat had significantly elevated after diet intervention(18.19±8.39 vs 19.68±8.87)(P<0.05),According to SF-36,the rating-dimension scores elevated in physical function(RF),role physical(RP),general health(GH),vitality(VT),social ftinction(SF),role emotion(RE),mentai health(MH),mental component summary(MCS)and physical component summary(PCS)(P<0.05)of MHD patients after diet intervention,except bodily pain(BP)(P>0.05).Conclusion:Diet intervention could significantly improve the nutritional status and survival quality of MHD patients.