Effects of nutritional education on protein and energy wasting in hemodialysis patients

• Main Authors: Chen-Chen Kang, 康甄真
• Other Authors: Jane C-J Chao
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/30320939588145787312

碩士 === 臺北醫學大學 === 保健營養學研究所 === 98 === Protein-energy wasting (PEM) is very common in patients with chronic hemodialysis (CHD). Routine assessment and monitor in the nutritional status of protein and energy are crucial to prevent, diagnose and treat PEW, for the reason that PEW is strongly correlated with the increasing morbidity and mortality in CHD patients. This study was to investigate whether protein-energy malnutrition in the CHD patients can be improved after the intervention of three-session nutritional education. The patients were recruited from the teaching hospital in northern Taiwan. The screened subjects participated volunteerly after completing the consent form. The selected patients were divided by purposive sampling into two groups with 25 subjects in each: the control and intervention groups. This three-session nutritional education is given by one-to-one for 20~30 minutes in each session, and the topics for nutritional education in order included proper intake of protein and energy, the limitation and control of the diet, and eat-out and diet on holidays. After the analysis of body mass index (BMI), biochemical assessment, such as albumin, creatinine and total cholesterol, and malnutrition information score (MIS), the results revealed that after the intervention of the nutritional education, the cognition and attitude scores were significantly increased by 31 (P＜0.01) (out of full score 100) and 3 (P＜0.01) (out of full score 50), respectively. The intervention group also had a significant increase in BMI from 23.1 ± 4.2 to 23.4 ± 4.2 kg/m2. The biochemical assessment showed that serum albumin concentration in the intervention group increased significantly from 3.8 ± 0.2 to 4.0 ± 0.3 g/dL. However, the nutritional score of MIS in the invention group decrease significantly from 4.8 ± 2.4 to 3.8 ± 2.3. In conclusion, in addition to the significant improvement in cognition and attitude of CHD patients after the intervention of nutritional education, there is also obvious improvement observed in their BMI and albumin values. A dramatic decline in MIS is observed at the end of the study. All these results indicate nutritional education to CHD patients is crucial for their nutritional status. As the result, the continuous intervention of nutritional education is necessary to improve dietary habits of CHD patients, and furthermore, to decrease the risk of morbidity and mortality along with malnutrition in CHD patients.