Effects of individualized nutrition intervention on protein energy wasting and quality of life in maintenance hemodialysis patients

Objective To investigate the effects of individualized nutritional intervention on protein energy wasting (PEW) and quality of life in maintenance hemodialysis (MHD) patients.Methods A total of 70 patients with MHD in the Blood Purification Center of the People's Hospital of Changji from January 2016 to January 2017 were randomly assigned to individualized nutrition intervention group (group A, 40 cases) and control group (group B, 30 cases). Group A received nutrition education and individualized nutrition interventions from the nutrition team of doctors, dietitians and nurses. Every 3 months, group A was subjected to diet review, daily dietary analysis, data collection (anthropological indicators and biochemical indicators, to assess the status of nutritional intervention and nutritional status of the patients), nutrition follow-up and supervision. Group B received routine nutrition education for 12 months. The changes in PEW were comprehensively evaluated in 4 aspects:body mass reduction, muscle mass loss, biochemical index, insufficient protein intake and calorie intake. The quality of life of patients was assessed by the Kidney Disease Quality of Life Short Form (KDQOL-SFTM 1.3).Results 1 After intervention for 12 months, the incidence of PEW in group A (40.1%) was significantly lower than that (62.5%) before intervention, and that of group B (56.1%, P < 0.05). 2 After intervention for 12 months, the upper arm muscle circumference, triceps skin fold thickness, grip strength, serum albumin level and caloric intake in group A were increased as compared with those before intervention. The body mass index (BMI), hemoglobin level and total cholesterol level did not change significantly. The protein intake increased. 3 After intervention for 12 months, the total score of SF-36 (67.9±11.8), KDTA (67.1±10.6) and the scores of their several branch dimensions in group A were significantly higher than those in group B.Conclusions Individualized nutrition intervention can effectively improve the PEW and the quality of life of MHD patients, and improve long-term prognosis.