Protein nenrgy wasting (pew) is subclinically progressive in choronic dialysis patients

Abstract

Protein energy wasting (PEW) is the most important problem on chronic dialysis patients because it is closely related to the shortness of their lifetime. However, there have been few reports that clarified the body composition changes in chronic hemodialysis patients.We retrospectively analyzed the changes in body composition evaluated by the bioelectrical impedance analysis for 2 years on 188 chronic hemodialysis patients whose dialysis vintage was more than 2 years. The patients were divided into the next 2 groups; the Group A, 108 patients with BW loss less than 2 %, Group B, 80 patients with BW loss greater than or equal to 2 %. The valuables which could estimate the progression of BW loss were determined using the Chi-square test by the comparison of the Group A and B.In all subjects the mean post-dialysis BW was significantly reduced from 57.3 Kg to 56.6 Kg and the LBM was also reduced from 43.1 Kg to 42.6Kg, but the fat volume didn’t change. In the Group A the LBM didn’t change but the fat volume significantly increased. In the Group B both the LBM and the fat volume were significantly reduced. Age was significantly higher and nPCR was lower in the Group B than A. In our facilities 42.5% of the patients reduced their BW but the difference was very small as -1.2 % from the basal level. The results of this study suggest PEW might subclinical progressive even if the patients can keep their BW as changing their muscle to fat on chronic hemodialysis patients. Higher age and lower protein intake are the risk of PEW so we should promote the proper intake of protein and energy especially for elder dialysis patients.