The Effect of Improved Nutrition Care on the Progress of Hemodialysis Patients

The prevalence and incidence of chronic kidney disease in Taiwan are both at the top of the world. The major renal replacement therapy for patients with end-stage renal disease is hemodialysis. Dialysis patients have higher cardiovascular disease risk and mortality because of malnutrition and inflammatory. Dietary components are preventable factors of malnutrition and cardiovascular disease. To establish an adequate energy and ideal food pattern for hemodialysis patients to prevent their morbidity and mortality of hemodialysis patients with cardiovascular disease. This project is a 4-year prospective and intervention study from 2013 to 2017. In the prospective study, 300 chronic hemodialysis patients are expected to recruit from Taiwan’s hospitals and clinics. This study will divide into three phases. First, a cross-sectional study. To measure the rest energy expenditure for hemodialysis subjects, to analysis the total energy requirements among hemodialysis patients in Taiwan, hemodialysis patients in western countries and health subjects. Second, a prospective study is conducted. To compute an ideal dietary pattern to reduce the inflammation and malnutrition status to decrease the risk factors of cardiovascular disease. The major result in this study is the dietary pattern of hemodialysis patients associated with lower risk factors of cardiovascular disease, hospitalized rate, total mortality and cardiovascular disease mortality during 4 years follow-up. Third, an intervention study will conducted. Sixty chronic hemodialysis patients were recruited in the study. Thirty of them are in an intervention of dietary associated with lower cardiovascular disease risk, and the others maintain their usual dietary habits. To confirm this ideal dietary pattern could help hemodialysis patients in Taiwan good prognosis.