Background: Several studies suggest an association between improved survival and better nutritional status. It has been suggested that there is a correlation between dose of dialysis and nutritional status. However, in spite of the current practice, there are conflicting reports regarding the relationship between dose of dialysis or malnutrition, and biochemical outcome. In this article, we will discuss the impact of dose of dialysis on nutritional status and biochemical outcome in hemodialysis patients. We will also mention the interrelationships of dialysis dose, malnutrition, and biochemical outcome with respect to these patients. Methods: Data were processed on 134 dialysis patients (mean age 48.21 ± 13.38, 69 male, 65 female) on 3-times-per-week dialysis regimens. The overall study period was 3 months from June 1, 2005 to August 31, 2005. The patients were divided into two groups: the baseline group and the intervention group. The data of the baseline group were collected in June, 2005 and the data of the intervention group were collected in August, 2005 after applying the intervention or a protocol for dialysis adequacy improvement. Results: The statistical analysis demonstrated that there was a significant improvement in mean URR and Kt/V from the baseline to the intervention group. The intervention group had a considerably higher rate than the baseline group for all nutritional and biochemical outcome parameters. The study showed a strong positive correlation between nPCR and Kt/V (p = 0.0001) and also a strong positive correlation between serum albumin and Kt/V (p = 0.00001). No correlations were found between Kt/V and biochemical outcomes such as hemoglobin (p = 0.4922), calcium (p = 0.650), phosphate (p = 0.508), and phosphatase (p = 0.091). Conclusion: All the available evidence in hemodialysis patients confirms the close association between dialysis dose and biochemical outcome. A body of evidence also highlights the existence of relationship between malnutrition and outcome among these patients. Dose of dialysis and nutrition are considered to be interrelated.

Keywords:
Hemodialysis, Dialysis adequacy Kt/V, Nutrition
1.
Acchiardo SE, Moore LW, Latour PA: Malnutrition as the main factor in morbidity and mortality of hemodialysis patients. Kidney Int 1983;24:S199–S203.
2.
Dwyer JT, Cunniff PJ, Maroni BJ, Kopple JD, Burrows JD, Powers SN, et al: The Hemodialysis (HEMO) pilot study: nutrition program and participant characteristics at baseline. J Renal Nutr 1998;8:11–20.
3.
Harter HR: Review of significant finding from the NCDS and recommendations. Kidney lnt 1983;23(suppl 13):10712.
4.
Marckmann P: Nutritional status and mortality of patients in regular dialysis therapy. Lint Med 1989;226:429–432.
5.
Lowrie EG, Lew NL: Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 1990;15; 458–482.
6.
Owen WF, Lew NL, Lieu Y, Lowrie EG, Lazarus 1M: The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 1993;329:1001–1006.
7.
Hakim RM, Breyer J, Ismail N, Schulman G: Effects of dose of dialysis on morbidity and mortality. Am J Kidney Dis 1994;23:661–669.
8.
Lindsay RM: The influence of dialysis prescription and nutritional status on outcome of dialysis patients. Nefrologia 1994;14:25–31.
9.
Lindsay RM, Spanner E: A hypothesis: the protein catabolic rate is dependent upon the type and amount of treatment in dialyzed uremic patients. Am J Kidney Dis 1989;5:382–389.
10.
Blake P, Lindsay RM. Spanner E, et al: The relationship between Kt/V and normalized protein catabolic rate (nPCR) is not linear. Perit Dial Int 1993;13(suppl 1):S71.
11.
Yang CS: Dose of dialysis and nutrition in hemodialysis patients: association with clinical outcome. Acta Nephrol 1997;11:66–70.
12.
Daugirdas JT: Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol 1993;4:1205–1213.
© 2007 S. Karger AG, Basel
2007
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