Simplified Adequate Energy Requirements for Patients on Maintaince Hemodialysis in Taiwan: A Cross- Sectional Observation Study

Background: Taiwanese studies have typically shown that the average Dietary Energy Intake (DEI) of Hemodialysis (HD) patients was lower than that recommended by the National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines; however, these patients did not display a poor nutritional status. This study aimed to use the energy prediction equation to estimate simplified Appropriate Energy Requirements (AER) for Taiwanese HD patients. Design: This was a cross-sectional study with 108 HD patients. The demographic, anthropometric, and laboratory measurement data of the patients were obtained from a chart review. The dietary data were obtained from 3-day dietary records at the baseline and follow-up periods of the current study. Result: To maintain an ideal body weight and a healthy nutritional status, the AER for males is approximately 24.6 (kcal/IBW kg/day) and the AER for females is approximately 21.0 (kcal/IBW kg/day). Based on the DEI reached AER, a comparison of the nutritional parameters between the baseline and follow-up was non-significant. Male patients older than 60 years with adequate dietary energy showed higher serum albumin values and Geriatric Nutritional Risk Index (GNRI) scores in the follow-up compared with those at the baseline. Conclusion: The AER of Taiwanese HD patients may be lower than the recommendation of the K/DOQI guideline. We recommend an AER of approximately 21 to 25 (kcal/kg/day) to maintain an ideal body weight and a healthy nutritional status.