Relationship between dialysis and nutritional adequacy in haemodialysis patients

The nutritional wellbeing and dialysis adequacy of 57 stable haemodialysis patients (34 males and 23 females) from two satellite dialysis centres were assessed. Nutritional and anthropometric assessment comprised a variety of serological, historical and somatic parameters. A previously validated urea monitor was used to assess dialysis dose (Kt/V) and normalized protein catabolic rate (nPCR), Over 70% were malnourished (19% severely), 60% had a nPCR < 1.2 g/kg per day, and 80% failed to reach an adequate energy intake. A close correlation was observed between the various measures of nutritional assessment. Almost half of the group (47%) demonstrated a Kt/V < 1.2, with a significantly higher level identified in females (1.3 +/- 0.2 vs 1.0 +/- 0.2, P < 0.05). This was in contrast to the nutritional data where there was an equal sex distribution. A close correlation was found between dialysis adequacy and the different nutritional and anthropometric parameters in subjects with a Kt/V < 1.2 (P<0.01 to P<0.001). Males appear to be at higher risk of malnutrition from inadequate dialysis, however, a higher than expected incidence of malnutrition was observed in both sexes who were adequately dialysed.