The Clinical Significance of Nutrition Assessed by DEXA in Hemodialysis Patients

Kim, Byung Soo; Kim, Jin Dong; Shin, Mi Jung; Lee, Seung Hun; Kim, Suk Young; Choi, Euy Jin; Chang, Yoon Sik; Bang, Byung Kee

Abstract

BACKGROUND
Malnutrition is one of the important predictors for mortality in maintained hemodialysis patients. DEXA is known to be a useful method to assess the nutritional status of hemodialysis patients (Though the methods to detect malnutrition in HD paitents are SGA, anthropometric methods, and serological study, which one is the best thing is still controversial). METHODS: Ninety seven hemodialysis patients without acute infection, inflammation, and acute coronary syndrome were included. SGA, anthopometric examination, serologic studies, and DEXA were performed. RESULTS: Mean age was 54.6+/-13.1 years and hemodialysis duration was 57.7+/-47.0 (range: 3-180) months. There were significant differences in creatinine, protein, triglyceride, and prealbumin between well nourished and malnutrition group by SGA, but not in albumin, CRP, troponin T, and DEXA parameters. Between normal and high CRP group, creatinine, albumin, prealbumin, troponin T, TNFRII, CRP were different, but not in DEXA parameters. There were significant difference in creatinine, albumin, prealbumin, troponin T, TNFRII, CRP, MAMC between low and high LTLM groups. LTLM ratio was negatively correlated with age, CRP, and TNFRII, positively correlated with albumin, prealbumin, creatinine, and MAMC. Creatinine and TNFRII were independent parameters for LTLM by multivariate analysis. CONCLUSION: (DEXA was the useful tool for malnutrition in HD paients. Malnutrition may be assicaiated with inflammation and apotosis.) These findings suggest that malnutrition may be associated with inflammation and apoptosis in maintained hemodialysis patients.