Korean Journal of Nephrology 1995;14(1):107-114.

혈액투석중인 만성신부전 환자에서 영양상태가 불량한 환자의 특성에 관한 연구

김병훈 , 도준영 , 조인호 , 윤경우

Abstract

Serum albumin represents the nutritional status of protein, and serum cholesterol represents the status of energy of calorie in hemodialysis patients. We classified the patients into 5 groups according to serum allbumin and cholesterol concentrations', serum albumin >=4.0g/dL & cholestero1h150mg/dL (group A), serum albumin>=R4.0g/dL & cholesterol< 150mg/dL(group B), 3.5==150mg/dL(group C), 3.5==150mg/dL(group C), 3.5=Kserum albumin<4. Og/dL & cholesterol<150mg/dL(group D) and serum albumin<3.5g/dL & cholesterol<150 mg/dL (group E). Sixty nine hemodialysis patients with chronic renal failure were included in our study(male 39, femal 30, mean age 44.86 years, 14 65 years of age). Most common cause of chronic renal failure was unknown(N=28, 40%), and the other causes were diabetes mellitus(N = 13, 19 % ), glomerulone- phritis(N=11, 16%), hypertension(N=11, 16%), polycystic kidney disease(N=3, 4,3%), pyelonephri- tis(N=1, 1.5%), uric acid nephropathy(N=1, 1.5%) and renal tuberculosis(N=1, 1.5%). The group with serum albumin less than 3.5gm/dL and cholesterol more than 150mg/dL was excluded in this study be- cause there was only one patient in this group. The five groups were compared with age, sex, hemodialysis period, hemodialysis time during a month, weekly Kt/V urea, erythropoietin(E."0) in- jection, etiology of CRF, .nformation about oral in- take, economic status and amount of protein intake during the 3 days before hemodialysis. The mean age of group E(57.50±4.08) was significantly higher than that of group B(39.75±12.28)(p<0.05). Week- ly Kt/V urea index of group A(8.21±2.09) was sig- nificantly higher than groups D(5.88±1.82) and E (4.90±0.90)(p<0.05). There was no diabetic patient in normal control group A, whereas 9 of group D(29 patients) and 2 of group E(6 patients) were diabetic patients. Hemodialysis periods of diabetes induced CRF(20.77 ± 20.3months) were significantly shorter than those of glomerulonephritis induced CRF(63.5± 36.64months)(p<0.01). Serum albumin concentra- tion of EPO group(4.07±0.15g/dL) was significant- ly higher than that of non EPO group(3.80±0.32g/ dL) (p<0.05). Weekly Kt/V urea was significantly lower in male patients(5.35±1.27) than in female patients(7.61± 2.46)(p<0.01). Protein intake was significantly higher in male patients(3.15±0.71) than females(2. 47±0.76)(p<0.01) and economic status of EPO group(1.83±0.36) was significantly better than that of the non EPO group(1.12±0.41)(p<0.01). In con- clusion, more that half(group D & E) of hemo- dialysis patients with chronic renal failure are in a malnutritional state. Characteristics of hemodiaysis patients with poor nutritional status are DM, old age, low Kt/V urea index and non EPO group. It seems that nutrition is also related to economic status, be- cause nutritional status is better in the EPO injection group than the non EPO group.