Study of meal management from the relationship between the prognosis and salt intake of hemodialysis patients

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  • 外来血液透析患者の食塩摂取量と生命予後からみた食事管理の検討
  • ガイライ ケツエキ トウセキ カンジャ ノ ショクエン セッシュリョウ ト セイメイ ヨゴ カラ ミタ ショクジ カンリ ノ ケントウ

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Abstract

 A study was conducted on salt intake in hemodialysis patients. We studied 547 patients who had been undergoing maintenance hemodialysis treatment for over two years as of April 2005 to measure the distribution and fluctuation of their salt intake and examine the connection between age, weight and blood pressure. Using the calculation of salt intake at the start of the observation, which was stratified into five groups (less than 6 grams, 6 to 8 grams, 8 to 10 grams, 10 to 12 grams, over 12 grams), and the survival rates measured during the period of the observation, we performed a comparison of salt intake and survival rate in patients below the age of 66 as well as those over the age of 66. The salt intake declined with increase in age and was higher in patients with higher body mass index, but no correlation was found with blood pressure (average BP). The hazard ratio was lower at all levels of salt intake from 6 to 12 g than at less than 6 g by regression analysis. Therefore, it cannot be said that a better prognosis can be maintained by a salt intake of less than 6g. In the group aged over 66, patients with a lot of salt intake were not significantly different, but the survival rate was higher. The recommended salt intake for HD patients is less than 6 grams per day to prevent overflow; however, we believe it is necessary to set a target value for each individual considering age, weight, or level of physical activity, especially since salt intake is largely associated with diet. For elderly patients whose appetites are declining, nutritional guidance should focus on “maintaining the physical condition,” not on the “limitation” of salt and water intake.

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