Abstract
The amount of dietary protein intake in hemodialysed patients was estimated two times, in 1987 and 1992, utilizing the urea kinetics model (UKM). The values obtained from UKM as well as nutritional assessment were also examined with regards to patient survival in order to determine whether these values are useful for predicting patient survival. The values calculated from records of dietary interviews (DPI) showed an excellent positive correlation with the protein catabolism rate (PCR) values assessed from the UKM study. Therefore, estimation of individual protein intake seems to be possible from the UKM study alone. The nutritional status and prognosis of patients were studied by dividing the patients into three groups; diabetic, elderly (more than 60 years old), and control. The two former groups showed worse survival than the control group and those who showed higher BUN/creatinine ratios, and lower serum albumin and poor anthropometries. The data measured in 1987 revealed that the patients with either a high BUN/creatinine ratio, more than 7.0, low serum albumin, less than 3.0g/dl, had poor survival during the 5 year follow-up period. Thus, these values seem to be hallmarks for predicting patient prognosis. The amount of protein intake was decreased in 1992 compared to that of 1987. This might reflect the good compliance of these patients with dietary guidelines, since the dieticians in our hospital are recommending restricted protein intake in order to prevent skeletal complications. Though the efficiency of hemodialysis evaluated by Kt/V analysis was optimal in the majority of patients, diabetic patients showed the worst value among the three groups. This suggests that revision of hemodialysis techniques is necessary for diabetic patients to achieve better results. Whether the amount of protein prescribed to patients, 1.1g/Kg/day, is enough is a question which must be resolved in the future.
