The Japanese Journal of Clinical Dialysis Vol.19 No.13(2-5)

Theme New Nutritional Assesment for Dialysis Patients
Title Method for nutritional assessment-based on exercise ability
Publish Date 2003/12
Author Keiko Inoue Department of Clinical Nutrition, Shinseikai Daiichi Hospital, School of Life Studies, Sugiyama Jogakuen University
Author Masahiko Kato School of Life Studies, Sugiyama Jogakuen University
[ Summary ] Patients receiving dialytic treatment may easily fall into a state of chronic lack of exercise. In comparison with the JARD 2001 (Japanese Anthropometric Reference Data 2001), arm muscle circumference(AMC), arm muscle area (AMA), and calf circumference (CC) are significantly lower than in the average Japanese. In addition, the decrease in of %CC in a lower ADL group was also significant, and the loss of muscular strength in the lower limbs was an impediment to walking, suggesting it is one of the factors decreasing ADL. Grasping power, which is an index of whole-body muscular strength, has a significant correlation with AMA, and it should thus be added to any nutritional assessment. In the lower AMA group (% AMA under 80%), the "Physical and Mental Daily Role Functions", which are psychological and physical factors impacting work and activity of SF-36, significantly declined. In KDQOL, the "influence on daily life" and "burden of kidney disease" also significantly diminished. Since the loss of muscle affects the performance of housework, mental and physical stress, and anxiety, resulting in lower QOL and ADL, it is important for the dietitian to focus not only on nutritional guidance, but to encourage the patient to make exercise a part of his/her life, which the kind of easy exercise that will become a life-long habit.
back