【Objectives】　The significance of the body mass index（BMI） in hemodialysis patients in Japan is not sufficiently clear. The relationship between the 5-year survival prognosis and BMI in maintenance hemodialysis patients at our facility was investigated. 【Methods】　The 5-year survival of 988 patients undergoing maintenance hemodialysis at our institution was studied. The cumulative survival rate was calculated for each BMI stratum among the overall population, group <70 years old and group ≥70 years old. And each group was also divided with or without diabetes status. 【Results】5-year outcomes were 573 alive, 236 dead, and 179 moved out. Multivariate analysis showed that the death group had a higher proportion of males, higher prevalence of diabetes, higher age, lower serum albumin levels and lower BMI than the survival group. These results were statistically significant. There was no significant difference in cumulative survival by BMI class in the non-diabetic group aged <70 years, whereas in the diabetic group lower BMI was associated with lower cumulative survival. In the age group of ≥ 70 years, the cumulative survival rate was lower with lower BMI in both the non-diabetic group and the diabetic group, and the cumulative survival rate was lower in the diabetic group than in the non-diabetic group. The BMI cutoff for 5-year mortality in hemodialysis patients ≥70 years old was 19.7 kg/m2, with an odds ratio of 2.2278. Lower BMI tended to be associated with higher mortality from infections and lower mortality from malignancies. 【Conclusion】 5-year cumulative survival rates for hemodialysis patients tended to be lower with lower BMI, except for the non-diabetic group aged <70 years. Especially in the elderly≥70 years old, it seems important to manage nutrition so that BMI does not fall below 20kg/m2.

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【Purpose】 Constipation is a major complication in patients with severe motor and intellectual disabilities MID). In a　pilot study of home-healthcare patients with disabilities including SMID, we found that consumption of malted rice amazake for six weeks could alleviate constipation symptoms. To properly evaluate the effect of malted rice amazake intake on the defecation status, a comparative control study was conducted in the current study. 【Methods】 Ten patients in the intervention group consumed malted rice amazake, and 11 patients in the control group consumed water or lukewarm water daily for six weeks. Additionally, the physical condition, diet, medications, and defecation status of the participants were investigated. 【Results】 The Japanese version of the constipation assessment scale showed no change in the control group. However, a decreasing trend was observed in the intervention group. The Bristol stool scale was used to classify stools into three categories： (type 1-2), normal (type 3-5), and soft (type 6-7). The percentage of the occurrence of the three categories was analyzed in participants before and after the intervention period. The intervention group showed a greater reduction in soft stools after the intervention than the control group. This was similar to the reduction in the diarrhea group only in the intervention group shown in the revised “Bowel Movement Pattern Classification Flowchart”. 【Conclusion】 Intake of malted rice amazake for six weeks may alleviate constipation symptoms in home-healthcare patients with disabilities including SMID. These changes may be accompanied by changes in stool shape.

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[in Japanese]

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