Newsletter

[ Vol. 12 No. 3 ] (September - December 2011 )
Chronic Malnutrition in end stage disease (ESRD) - The true state

Zaki Morad Mohamad Zaher
InternationalMedical University and Universiti Teknologi MARA, Malaysia

The high prevalence of end-stage renal disease (ESRD) in many Asian countries is attributed to diabetes and hypertension. Health care expenditure in relation to per capita income and government share of this expenditure vary among Asian countries and are affected by large populations and the poverty factor. For many patients who reach end stage renal failure, maintenance haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are the major renal replacement therapy options. Both modalities cannot mirror the physiology of the normal kidney in supporting body homeostasis for continuous and efficient removal of water and waste products. Even though the K-KOQI guidelines for energy and protein recommendations and controlling serum mineral levels are well established for the nutrition management of ESRD patients, at the ground level there are issues in achieving clinical targets as malnutrition is the veritable skeleton in the closet of ESRD patients. This presentation highlights retrospective data analysis by the National Renal Registry indicating patient survival is critically affect by nutritional status. Survival in both HD and CAPD patients were strongly correlated to serum albumin level with levels > 3.5g/L conferring better survival outcomes. Of interest a higher body mass index (BMI > 25.0) also conferred a survival benefit in both patient groups.

From  
PENSA 2009}
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 56