Abstract
A case-controlled, 12 week follow-up, study was designed to investigate the effect of dietician-delivered medical nutrition therapy (MNT) on the nutritional status and quality of life in hemodialysis patients. Subjects were recruited at Kyung-Hee Medical Center and were randomly assigned to two groups : the control and the MNT group. The MNT group received individualized MNT for 12 weeks. The results were as follows: 1) The mean ages of the control (n = 20) and MNT (n = 24) groups were 50.6 $\pm$ 14.8 and 45.7 $\pm$ 14.0 years, and the mean durations of dialysis were 2.3 $\pm$ 2.3 and 1.7 $\pm$ 1.9 years, respectively. The interdialysis weight gain of the subjects was higher than that recommended. 2) The indicators of the subjects nutritional status showed that S to 25% of the subjects had some degree of malnutrition, with most of them in the mild malnutrition category. 3) After 12 weeks of the experiment, the percentage of the ideal body weight (% IBW) of the control group decreased, but that of the MNT group increased. Changes in other anthropometric parameters in both groups during the study period were not significantly different. 4) At the beginning of the study, the 54% of the MNT group consumed more than 28 kcal/kg body weight/day and 50% consumed more than 1.0g protein/kg body weight/day. However, these percentages rose to 71% and 75%, respectively, after 12 weeks of the individualized MNT. 5) The serum albumin and blood urea nitrogen (BUN) levels of the control group decreased significantly artier 12 weeks of the experiment, while those of the MNT group did not change. 6) After 12 weeks of individualized MNT, the mean score of nutrition knowledge and total mean score of quality of life (QL) of the MNT group were significantly higher than that of th\ulcorner control group. Body pain and social functioning scores of the MNT group were significantly higher than those of the control group. The positive effect of individualized MNT on the hemodialysis patients consisted of their improved nutritional status, nutritional knowledge, and the quality of life. These results suggest that individualized MNT continuously performed by a dietitian can be helpful for hemodialysis patients. However, larger and longer term studies are needed to confirm these positive effects of MNT. In addition, the development of nutritional education programs for MNT is needed to increase the positive impact of MNT.