Malnutrition and Dialysis

  • Denis Fouque
  • Joel D. Kopple


Several studies indicate that in patients undergoing maintenance hemodialysis (MHD) or chronic peritoneal dialysis (CPD), a low dietary protein intake as well as biochemical markers of protein or calorie malnutrition are associated with increased morbidity and mortality. MHD patients with low serum urea nitrogen (SUN) levels or decreased protein nitrogen appearance (also referred to as PCR) have increased morbidity or mortality (1, 2). Since in MHD patients, low SUN is associated with low dietary protein intake, these data suggest that decreased dietary protein intake is a risk factor for mortality. In 98 non-diabetic MHD patients followed for 12 months, an inverse relationship has been observed between the protein nitrogen appearance and the frequency of hospitalizations and mortality rate (2). In 1990, Lowrie and Lew showed that, in over 12,000 MHD patients followed for 12 months, of various predialysis serum chemistries, the serum albumin exhibited the most striking odds ratio for survival (3). The odds ratio for mortality rose exponentially as serum albumin fell.


Peritoneal Dialysis Chronic Renal Failure Hemodialysis Patient Dietary Protein Intake Chronic Peritoneal Dial 
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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Denis Fouque
    • 1
  • Joel D. Kopple
    • 2
  1. 1.Department of Nephrology Hôpital Edouard HerriotUniversity Claude BernardLyon Cédex 03France
  2. 2.Harbor-UCLA Medical CenterTorranceUSA

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