Relationship between the target dose for hemodialysis adequacy and nutritional assessment

Abstract

BACKGROUND: Some studies have shown an increased relative risk of death for patients with higher levels of Kt/V, which may be associated with marked malnutrition. OBJECTIVE: The aim of this study was to investigate the relationship between the target dose for hemodialysis adequacy, as measured by Kt/V, and various nutritional parameters in hemodialysis patients. DESIGN: Cross-sectional. SETTINGS: Sakarya University Faculty of Medicine, Turkey between February 2014 and March 2014. PATIENTS AND METHODS: For consecutive patients who met criteria, the following were recorded: nutritional status, dialysis malnutrition score (DMS), the geriatric nutritional risk index (GNRI), serum albumin level, anthropometric measurements, and bioelectrical impedance analysis. Patients were classified into two groups according to the target hemodialysis dose for single-pool Kt/V: patients with spKt/V ≥1.4 and patients with spKt/V <1.4. MAIN OUTCOME MEASURE(S): Association of hemodialysis adequacy by nutritional assessment. RESULTS: The prevalence of malnutrition in 286 patients with target dose hemodialysis (spKt/V ≥ 1.4) was significantly higher according to body mass index (BMI), DMS, and GNRI (P=.001, P=.006, and P=.004, respectively) compared with patients with a lower target dose (spKt/V < 1.4). BMI, biceps skinfolds, mid-arm circumference, calf circumference, fat free mass, and total body water were statistically significantly lower in patients at a higher target dose (spKt/V ≥ 1.4) (P<.001, P=.034, P=.010, P<.001, P<.001, and P<.001 respectively). CONCLUSIONS: Malnutrition was more frequent in chronic hemodialysis patients who received the target hemodialysis. Evaluation of nutritional status in patients at the target hemodialysis dose should be considered. LIMITATIONS: Data collected from a single region; small sample size; cross-sectional design is disadvantageous.