Taipei Medical University
T
he
E
ffect of
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ender
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nd
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ge
o
n
N
utritional
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tatus
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f
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emodialysis
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atients
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ntroduction
The prevalence of malnutrition is high in dialysis patients. Malnutrition increases the morbidity and mortality. However, elder hemodialysis patients have less dietary intake. Poor dietary intake is one of the major cause of malnutrition among dialysis patients. Besides, women eat less dietary energy and protein than men which may contribute to increase malnutrition risk.
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bjective
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ubjects and Methods
R
esults and Discussion
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onclusion
Wu HC
1,Lin WC
2, Wu PY
3, Yang SH
1,41.2.3
School of Nutrition and Health Sciences, Taipei Medical University
4Nutrition research center, Taipei Medical University Hospital
This study purpose is to find out the effect of gender and age on nutritional status of hemodialysis patients.
One hundred and seven chronic hemodialysis(CHD) subjects were recruited from Wanfang Hospital and Taipei Medical University Hospital in Sep. 2010. All subjects had hemodialysis treatment at least 3 months. Subjects were divided into tertile groups by age, ≥50 years, 51-70 years and > 70 years.
The data of demographic, anthropometric and laboratory were collected. Serum albumin, creatinine, and GNRI (geriatric nutritional risk index) score were used as nutrition status marker. All subjects wrote 3-day dietary records, and analyzed their dietary energy and protein intake.
All values presented as mean ± SE or number. We used
t test to compare data between male and female subjects,
and one way ANOVA or chi-square test to compare with different age group. When p value less than 0.05 was considered as significantly different.
There was no significantly malnutrition different in CHD patients between gender, but significantly different among age groups, especially older than 70 years old.
Table 2. Data of demographic, anthropometric, laboratory and dietary among subjects were ≦50 years, 51-70 years or ＞70 years.
≦50 years 51-70 years ＞70 years BMI, kg/m2 24.1 ± 0.7a 23.4 ± 0.6ab 21.7 ± 0.5b Male, n(%) 17(48.6) 17(48.6) 19(51.4) Albumin, g/dl 4.1 ± 0.1a 4.0 ± 0.1ab 3.8 ± 0.1b GNRI 100.8 ± 1.2a 99.5 ± 0.9ab 95.9 ± 1.2b Hemoglobin, mg/dl 10.6 ± 0.3 10.6 ±0.2 10.3 ± 0.2 Creatinine, mg/dl 13.0 ± 0.4a 9.4 ± 0.4b 8.9 ± 0.4b Potassium, mEq/L 4.9 ± 0.1a 4.4 ± 0.1b 4.5 ± 0.1ab Phosphate, mg/dl 5.8 ± 0.2a 4.9 ± 0.2b 4.7 ± 0.2b Ca×PO4, mg2/dl2 55.3 ± 2.5a 45.3 ± 2.1b 43.5 ± 1.9b Kt/V 1.64 ± 0.05 1.62 ±0.05 1.63 ± 0.05
Dietary calorie, kcal/kg 23.1 ± 1.2 25.3 ±1.5 24.7 ± 1.3 Dietary protein, g/kg 0.85 ± 0.1b 1.00 ± 0.1ab 1.05 ± 0.1a
Comparing to male hemodialysis patients, the female patients had similar level of all nutrition status markers (p > 0.05, table 1). No significantly different in characteristic data and dietary intake between gender. Subjects who were more than 70 years had significantly lower BMI (body mass index), GNRI score, serum albumin and creatinine than those fifty and less (p < 0.05, table 2). Therefore, elder subjects may have poorer nutritional status than younger subjects. Previous studies showed that elder people loss their body weight more than 0.68kg per year, and most of lost body weight is muscle mass. Ageing caused lower serum albumin level and maybe one of the malnutrition risk factors of hemodialysis patients.
However, we did not find elder subjects had significantly decreased dietary energy and protein intake. Maybe inadequate dietary energy and protein intake were not major contributors of malnutrition in these patients.
Table 1. Data of demographic, anthropometric, laboratory and dietary between male and female.
Male (n = 53) Female (n = 54) p Age, years 64.3 ± 1.9 62.5 ± 2.1 0.545 BMI, kg/m2 23.0 ± 0.5 23.1 ± 0.6 0.889 Hemoglobin, mg/dl 10.7 ± 0.2 10.3 ± 0.2 0.071 Albumin, g/dl 4.0 ± 0.0 3.9 ± 0.1 0.175 Creatinine, mg/dl 10.9 ± 0.4 10.0 ± 0.4 0.111 Potassium, mEq/L 4.5 ± 0.1 4.6 ± 0.1 0.325 Phosphate, mg/dl 5.3 ± 0.2 5.0 ± 0.2 0.229 Ca×PO4, mg2/dl2 49.7 ± 1.6 46.3 ± 2.1 0.197 Kt/V 1.54 ± 0.05b 1.71 ± 0.03a 0.005 GNRI 99.5 ± 0.8 97.9 ± 1.0 0.227
Dietary calorie, kcal/kg 24.6 ± 1.1 24.2 ± 1.1 0.792 Dietary protein, g/kg 0.97 ± 0.05 0.97 ± 0.04 0.982
Variable are expressed as mean ± SE. BMI: body mass index; BUN, blood urea nitrogen;; Ca×PO4, calcium phosphate product; Kt/V; GNRI, geriatric nutritional risk index; Values with different superscripts are significantly different at p<0.05 by Student's t test.
Variable are expressed as mean ± SE or number.BMI, body mass index; BUN, blood urea nitrogen; Ca×PO4, calcium phosphate product; GNRI, geriatric nutritional risk index; Values in the same column with different superscripts are significantly different at p<0.05 by chi-square or ANOVA test.
