Abstract
The aim of this study was to clarify the incidence of protein-energy wasting (PEW) and its associations with clinical characteristics and daily nutritional intake in Japanese chronic hemodialysis (HD) patients. A total of 409 patients who had been receiving stable HD therapy for >6 months (mean age : 64±11 years, duration of HD : 8 (3-14) years, frequency of hypertension : 74.6%, body mass index : 21.1±3.4, % arm muscle area : 103±22%, serum albumin : 3.7±0.3 g/dL, energy intake : 30±6 kcal/kg ideal body weight (IBW), protein intake : 1.01±0.22 g/kg IBW) were enrolled. In total, 17.1% of the patients met ≥3 of the four diagnostic criteria for PEW determined by the International Society of Renal Nutritional Metabolism (ISRNM). Multivariate logistic analysis demonstrated that age, HD duration, and hypertension were independently associated with PEW (≥3 ISRNM criteria). Furthermore, after adjusting for these variables, meat intake of <46.7 g/day, fish intake of <41.7 g/day, and sugar intake of <9.0 g/day were determined as cut-off values associated with PEW based on receiver-operating characteristics curves [odds ratio (OR) : 2.74, 95% confidence interval (CI) : 1.55-4.85, p=0.001 ; OR : 2.04, 95%CI : 1.16-3.61, p=0.014 ; OR : 1.88, 95%CI : 1.05-3.37, p=0.033, respectively]. Poor protein or energy intake might be associated with PEW in chronic HD patients.
