Correlation between adequacy of dialysis and overall nutrition status in the end stage renal disease population

Malnutrition among dialysis patients in the United States has been correlated with increased morbidity and mortality rates. Multiple factors are known to contribute to this problem, although inadequate dialysis (defined by Kt/v levels) has been postulated to be a major factor. One-hundred eighteen subjects were randomized into two groups during a 12 month period from December 1993 to November 1994 to assess the impact of two different Kt/v levels (1.2 vs 1.5) on nutritional parameters (albumin, nPCR, pre-dialysis BUN, total cholesterol) and clinical outcomes (dry weight, number and length of hospitalizations). Dialysis adequacy was measured using urea kinetic modeling. The average dose of dialysis (Kt/v) delivered to both groups was higher than initially targeted, 1.3 $\pm$ 0.03 for the control group and 1.6 $\pm$ 0.02 for the experimental group. Lab work was completed monthly. Urea kinetic modeling calculations for Kt/v and nPCR were calculated monthly. One hundred eight patients completed the study. No correlation was found between Kt/v and nutritional parameters. A significant correlation was observed between Kt/v levels and weight (p 0.0001, r = 0.92). No association was observed between Kt/v levels and number of days spent in the hospital or number of hospital admissions. An increase number of days for black males vs non black males was observed but not considered statistically significant. While this study showed no significant correlation between experimental group vs control group on nutritional and clinical outcomes, variation in these outcomes between different Kt/v levels may be more obvious over longer periods of time as demonstrated by other studies.