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KMID : 0350519940470021039
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Journal of Catholic Medical College
1994 Volume.47 No. 2 p.1039 ~ p.1051
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Evaluation of Nutritional Staus in Hemodialyis patients
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Abstract
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Maintenance of adequate nutritional status has been a major task in taking care of patients receiving hemodialysis (HD). This study purports to clarify their nutritional problems by measuring the changes of plasma amino acid before and after HD
and
by
examining their nutritional status as well.
Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by anthropometric measures, serum protein concentrations, plasma
amino
acid
concentration (AAC), the number of lymphocytes and immunoglobulin concentrations, and dietary intake. The data were analyzed by using chi-square test, t-test, and Pearson correlation coefficients. The results are following.
1. Among the HD patients, total AAC obtained after HD was significantly lower than that obtained before HD. This finding was due to the decreased total nonessential AAC. The ratio of total AAC over total essential AAC increased significantly
from.
31±04 before HD to .38±08 after HD. The HD group showed lower concentrations of total essential amino acids and higher concentrations of total nonessentional amino acids than the control group with statistical significance.
2. The HD group revealed significantly lower serum protein concentrations such as total protein, albumin, and transferrin than the control group.
3. The number of lymphocytes and the concentrations of Ig G, Ig A, and Ig M were significantly lower in the HD group than they were in the control group.
4. Regarding the anthropometric measures, body mass index, midarm circumference, and triceps skinfold thickness were significantly lower in the HD group than in the control group.
5. Among the HD patients, caloric intake was significantly less than the recommended daily allowance(RDA), but the protein intake was significantly more than the RDA with statistical significance in both cases.
6. Anthropometric measures were significantly associated between themselves. They also associated with significantly the number of lymphocytes, caloric and protein intakes. In particular, the total protein concentration was significantly
correlated
with Ig G, Ig A and Ig M, respectively. The total essential AAC was significantly associated with total protein and BUN. In addition, significantly high correlations were significatly found between caloric and protein intakes and between the
total
essential AAC and total nonessential AAC.
The above findings indicate that the HD patients have poor nutritional status and imbalance of plasma amino acids. Accordingly, supply of essential amino acids turned out to be crucial for caring HD patients. Nurses are also encouraged to adopt
anthropometric measures to examine nutritional status of HD patients.
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KEYWORD
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