Abstract
The protein intake standard for hemodialysis patients receiving hemodialysis, 1.0-1.2 g/kg/day, is higher than that recommended for healthy individuals because of protein and amino acid leakage and nutrition disorder due to hemodialysis. Meanwhile, high protein intake increases phosphorus and potassium intake to cause hyperphosphatemia or hyperpotassemia. Optimal protein intake for hemodialysis patients was studied from the viewpoint of physical and mental health sciences. Thus, the authors studied the possibility of protein intake of less than 1.0 g/kg/day for controlling serum phosphorus and serum potassium and maintaining nutrition status, and the mental stress of the patients caused by decreased protein intake. For one year from July 2000, 77 hemodialysis patients were studied by dividing by their normalized protein catabolic rate (nPCR in g/kg/day), calculated from their annual blood data to represent their protein intake, into the groups of nPCR from 0.6 to less than 0.8, from 0.8 to less than 1.0, and 1.0 or higher. The patients in the groups were compared in terms of their physical background and mental state. No significant difference was found in the age, dialysis history, BMI, energy intake and serum albumin between the groups, while the serum phosphorus, urea nitrogen and serum potassium decreased with decreasing nPCR. No significant difference was found in their mental state represented by the State-Trait Anxiety Inventory and the Sense of Coherence; thus, mental stress due to restricted protein intake was not observed. The Kidney Disease Quality of Life instrument showed better scores in social functioning, mental health, effect of kidney disease and burden of kidney disease in the group with low nPCR. Protein intake of less than 1.0 g/kg/day was estimated to be appropriate both physically and mentally for hemodialysis patients.
