Korean Journal of Nephrology 2002;21(1):129-136.

원저 : 혈액투석 환자의 통상 칼로리 및 단백질 섭취량이 18 개월 후의 영양상태 - 알부민 및 인체계측지표를 중심으로 - 에 미치는 영향 (Original articles : Influence of Routine Calorie and Protein Intake on Nutritional Status in Stable Chronic Hemodialysis Patients : A 18 Months Follow - up Study)

이현택(Hyen Tac Lee),조성(Seong Cho),이성호(Sung Ho Lee),김성록(Sung Rok Kim),김양하(Yang Ha Kim),서예정(Hye Jeong Seo)

Abstract

Background
: Dialysis patients as a group appear to have a caloric and a protein intake less than the recommended values; because their energy expenditure is not different from that of healthy adults and because amino acid loss and increased catabolism during dialysis they should be in negative caloric & nitrogen balance and lose body mass and protein such as albumin progressively. Recently, papers dissenting about recommended protein intake in DOQI guideline were published. Because Korean people had different body size and dietary pattern from white races, recommanded protein and calorie intake may be different from that of white races. Methods : We retrospectively analyzed our data in a group of hemodialysis patients who had dietary evaluations and kinetic measurements performed two consecutive times over a period of 18 months. Results : Body weight(55.22±9.48 kg to 57.39±10.29 kg, p=0.008), LBM(lean body mass, 42.79±7.49 kg to 46.09±7.13 kg, p=0.000), BMI(Body Mass Index, 21.89±3.21 kg/m2 to 22.75±3.53 kg/m2, p=0.007) and serum albumin level(3.65±0.47 g/dL vs 3.87±0.42 g/dL, p=0.000) were increased compared to initial values. Fat mass, TSF(Triceps Skin Fold thickness), MAC(Mid-Arm Circumference), MAMC(Mid- Arm Muscle Circumference) were remained stable over this period of time. These results suggested that these patients are not in negative energy and nitrogen balance. Conclusion : Albumin and body weight remained stable over a period of 18 months in spite of 27.25±6.39 kcal/kg calorie intakes and 1.03±0.43 g/kg protein intakes. Recommanded protein and calorie intake of Korean people may be different from that of white races. (Korean J Nephrol 2002;21(1):129-136)