| [ Summary ] |
Protein energy malnutrition has been shown to be highly prevalent and associated with increased morbidity and mortality in maintenance dialysis patients. Malnutrition is believed to be caused by inadequate protein and energy intake, chronic inflammation, endocrine disorders, metabolic acidosis, loss of nutrients into the dialysate, and dialysis induced catabolism. A variety of methods are available for the assessment of nutritional status in dialysis patients, including assessment of food intake, physical examination, anthropometry, laboratory tests, and nutritional scoring systems. Because foods high in protein are a main source of dietary phosphorus, imposing dietary phosphorus restriction is often associated with a reduction in dietary protein intake leading to malnutrition. It has been reported that there is a connection between low phosphorus levels and higher mortality rates in dialysis patients. This association may be due to reduced protein intake and worsening nutritional status in patients with hypophosphatemia. |