Journal of the Korean Dietetic Association (대한영양사협회학술지)

The Korean Dietetic Association (대한영양사협회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Nutrition Education and Regular Exercise on Nutritional Status, Quality of Life and Fatigue in Hemodialysis Patients

영양교육과 규칙적인 운동이 혈액투석환자의 영양상태와 삶의 질 및 피로도에 미치는 효과

  • 김민지 (한양대학교 식품영양학과) ;
  • 박찬남 (한양대학교병원 간호국) ;
  • 강영의 (한양대학교병원 간호국) ;
  • 이상선 (한양대학교 식품영양학과)
  • Received : 2013.09.03
  • Accepted : 2013.10.17
  • Published : 2013.11.02
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the effects of a nutrition education and exercise on nutritional status in hemodialysis patients, with regard to quality of life (QoL), and fatigue. The subjects were divided into two groups : an educated (E) group (11 men and 9 women) and a non-educated (NE) group (7 men and 22 women). The educated group received a nutrition education and a regular exercise program for 3 months. Data on anthropometric indices and biochemical parameters were obtained from medical records. Dietary habits and nutrient intake were assessed through questionnaires and three-day food records. QoL (through the SF-36 questionnaire) and fatigue (measured by a visual analogue scale questionnaire) were assessed before and after the interventions. Dietary habit scores regarding food variety and fluid intake control significantly increased (P<0.05) after the nutrition education. Furthermore, the intake of total energy, carbohydrates, Fe, and vitamin A significantly increased (P<0.05). Vitamin C intake also significantly increased (P<0.01). Hb levels decreased whereas TG levels increased in the NE group. BUN levels decreased in the E group. After the nutrition education, QoL aspects, such as feelings of pain and general health, and the total score significantly increased (P<0.05) and the level of fatigue score decreased (P<0.01). The results of this study indicate that nutrition education and exercise for hemodialysis patients provides changes in dietary habit, daily nutrient intake, biochemical parameters, QoL, and the level of fatigue. Therefore, nutrition education and exercise help improve nutritional status and QoL.

Keywords

References

  1. Azar AT, Wahba K, Mohamed AS, Massoud WA (2007): Association between dialysis dose improvement and nutritional status among hemodialysis patients. Am J Nephrol 27(2):113-119 https://doi.org/10.1159/000099836
  2. Bennett PN, Breugelmans L, Barnard R, Agius M, Chan D, Fraser D, McNeill L, Potter L (2010): Sustaining a hemodialysis exercise program: a review. Semin Dial 23(1):62-73 https://doi.org/10.1111/j.1525-139X.2009.00652.x
  3. Chen J, Peng H, Zhang K, Xiao L, Yuan Z, Chen J, Wang Z, Wang J, Huang H (2013): The insufficiency intake of dietary micronutrients associated with malnutrition-inflammation score in hemodialysis population. PLoS One 8(6):e66841 https://doi.org/10.1371/journal.pone.0066841
  4. Cho YW, Kim KB (1998): Nutrition education of medical area in Korea. Korean J Nutr Autumn Forum pp.52-56
  5. Denhaerynck K, Manhaeve D, Dobbels F, Garzoni D, Nolte C, De Geest S (2007): Prevalence and consequences of nonadherence to hemodialysis regimens. Am J Crit Care 16(3):222-235
  6. Jin DC, Ha IS, Kim NH, Lee SW, Lee JS, Yoon SR, Kim BS (2012): Brief report - Renal replacement therapy in Korea, 2010. Kidney Res Clin Pract 31(1):62-71 https://doi.org/10.1016/j.krcp.2012.01.005
  7. Johansen KL, Painter PL, Sakkas GK, Gordon P, Doyle J, Shubert T (2006): Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: A randomized, controlled trial. J Am Soc Nephrol 17(8):2307-2314 https://doi.org/10.1681/ASN.2006010034
  8. K/DOQI guidelines of nutritional in chronic renal failure (2000): Am J Kidney Dis 35(6):S40-45 https://doi.org/10.1016/S0272-6386(00)70299-X
  9. Kadiri Mel M, Nechba RB, Oualim Z (2011): Factors predicting malnutrition in hemodialysis patients. Saudi J Kidney Dis Transpl 22(4):695-704
  10. Kakiya R, Shoji T, Tsujimoto Y, Tatsumi N, Hatsuda S, Shinohara K, Kimoto E, Tahara H, Koyama H, Emoto M, Ishimura E, Miki T, Tabata T, Nishizawa Y (2006): Body fat mass and lean mass as predictors of survival in hemodialysis patients. Kidney Int 70(3):549-556
  11. Kalantar-Zadeh K, Unruh M (2005): Health related quality of life in patients with chronic kidney disease. Int Urol Nephrol 37(2):367-378 https://doi.org/10.1007/s11255-004-0012-4
  12. Kim HJ (2011): Effects of nutrition education on dietary behaviors and nutritional status in hemodialysis patients. Masters degree thesis. Chungang University. pp.1-78
  13. Kim YH, Seo HJ, Kim SR (2001): A study of the nutritional status, nutritional knowledge, and dietary habits of the hemodialysis patients. Korean J Nutr 34(8):920-928
  14. Koh SB, chang SJ, Kang MG, Cha BS, Park JK (1997): Reliability and validity on measurement instrument for health status assessment in occupational workers. J Prev Med Pub Health 30(2):251-265
  15. Kopple JD (1997): McCollum Award Lecture, 1996: protein-energy malnutrition in maintenance dialysis patients. Am J Clin Nutr 65(5):1544-1557
  16. Kuhlmann MK, Levin NW (2008): How common is malnutrition in ESRD? New approaches to diagnosis of malnutrition. Blood Purif 26(1):49-53 https://doi.org/10.1159/000110564
  17. Lee KA, Hicks G, Nino-Murcia G (1991): Validity and reliability of a scale to assess fatigue. Psychiatry Res 36(3): 291-298 https://doi.org/10.1016/0165-1781(91)90027-M
  18. Lee NY (2006): The effects of nutrition education and counseling on nutritional status and quality of life in hemodialysis patients. Masters degree thesis. Hanyang University. pp.1-94
  19. Lee YM (2011): Evaluation of the effectiveness of nutrition education and counseling on the diet therapy practices of hemodialysis patients. Masters degree thesis. Kyungpook National University. pp.1-107
  20. Manfredini F, Mallamaci F, Catizone L, Zoccali C (2012): The burden of physical inactivity in chronic kidney disease: is there an exit strategy? Nephrol Dial Transplant 27(6):2143-2145 https://doi.org/10.1093/ndt/gfs120
  21. Martin-del-Campo F, Batis-Ruvalcaba C, Gonzalez-Espinoza L, Rojas-Campos E, Angel JR, Ruiz N, Gonzalez J, Pazarin L, Cueto-Manzano AM (2012): Dietary micronutrient intake in peritoneal dialysis patients: relationship with nutrition and inflammation status. Perit Dial Int 32(2):183-191 https://doi.org/10.3747/pdi.2010.00245
  22. Mehrotra R, Kopple JD (2001): Nutritional management of maintenance dialysis patients: why aren't we doing better? Annu Rev Nutr 21:343-379 https://doi.org/10.1146/annurev.nutr.21.1.343
  23. Mekki K, Remaoun M, Belleville J, Bouchenak M (2012): Hemodialysis duration impairs food intake and nutritional parameters in chronic kidney disease patients. Int Urol Nephrol 44(1):237-244 https://doi.org/10.1007/s11255-010-9875-8
  24. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention (2011): 2011 National health statistics - The 5th Korea National Health and Nutrition Examination, the second year. pp.60
  25. Mun YI, Oh JM (2002): The factors influencing the health-related QOL in hemodialysis patients. J Kor Soc Hosp Pharm 19(3):269-282
  26. Murtagh FE, Addington-Hall J, Higginson IJ (2007): The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis 14(1):82-99 https://doi.org/10.1053/j.ackd.2006.10.001
  27. Painter PL, Nelson-Worel JN, Hill MM, Thornbery DR, Shelp WR, Harrington AR, Weinstein AB (1986): Effects of exercise training during hemodialysis. Nephron 43(2):87-92 https://doi.org/10.1159/000183805
  28. Park HNC, Yoon HB, Lee HJ, Han SS, Son MJ, Jung ES, Joo KW, Lim CS, Chae DW, Ahn CR, Han JS (2008): Depression and quality of life in maintenance hemodialysis patients. Korean J Nephrol 27(1):228
  29. Raimann JG, Levin NW, Craig RG, Sirover W, Kotanko P, Handelman G (2013): Is vitamin C intake too low in dialysis patients? Semin Dial 26(1):1-5 https://doi.org/10.1111/sdi.12030
  30. Reboredo Mde M, Henrique DM, Faria Rde S, Chaoubah A, Bastos MG, de Paula RB (2010): Exercise training during hemodialysis reduces blood pressure and increases physical functioning and quality of life. Artif Organs 34(7):586-593 https://doi.org/10.1111/j.1525-1594.2009.00929.x
  31. Seo HJ (2002): A study on effect of nutrition education in hemodialysis patients. Masters degree thesis. Changwon National University. pp.1-79
  32. The Korean Dietetic Association (1997): Food Exchange List for Kidney Failure Patients. Seoul. pp.2-20
  33. The Korean Society Nephrology (2009): Guide of chronic renal failure. Available from: http://ksn.or.kr/upload/thesis/S89-S94.pdf. Accessed August 26, 2013
  34. Theofilou P (2012): Quality of life and mental health in hemodialysis and peritoneal dialysis patients: the role of health beliefs. Int Urol Nephrol 44(1):245-253 https://doi.org/10.1007/s11255-011-9975-0
  35. Ware JE Jr, Sherbourne C (1992): The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473-483 https://doi.org/10.1097/00005650-199206000-00002
  36. WHO Expert Consultation (2004): Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363(9403):157-163 https://doi.org/10.1016/S0140-6736(03)15268-3
  37. Yang JL, Seo HJ, Kim YH (2003): Effects of nutrition on nutritional Status of hemodialysis patients. Korean J Nutr 36(7):749-758
  38. Yu JA, Lee YW, Kim JG (2000): A study on the perception of salt and food intake of hemodialysis patients. J Korean Public Health Assoc 26(1):104-115

Cited by

  1. Effects of Dietary Program based on Self-efficacy Theory on Dietary Adherence, Physical Indices and Quality of Life for Hemodialysis Patients vol.46, pp.4, 2016, https://doi.org/10.4040/jkan.2016.46.4.598
  2. Comparison Between Semi-Quantitative Frequency Methods and 7-day Dietary Records Methods in Food and Nutrition Intake Status For Hemodialysis Patients vol.22, pp.5, 2017, https://doi.org/10.5720/kjcn.2017.22.5.426