Medical Nutritional Therapy In Malnourish Chronic Kidney Disease Patients Who Undergo Hemodialysis (Approaching To Mid Upper Arm Muscle Circumference)
Muningtya Philiyanisa Alam (a), Diyah Eka Andayani (b), Lady Dhita Alfara (c)

a) Rumah Sakit Umum Daerah Menggala, Indonesia
b) Departemen Ilmu Gizi, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Cipto Mangunkusumo, Indonesia
c) Department Ilmu Gizi, Rumah Sakit Sumber Waras, Indonesia

Abstract

Chronic kidney disease has become a global epidemic disease and the prevalence is increasing in Indonesia. Hemodialysis (HD) is the most common treatment for end stage renal disease (ESRD) patients. Patients who undergo HD routinely are vulnerable to increase protein energy wasting (PEW) so nutritional status must be monitored closely. Mid upper arm muscle circumference (MUAMC) can be use to show the total body protein and muscle mass. Medical nutritional therapy is needed to prevent patients from PEW and improve the quality of life. Four patients age range 32-61 years and same sex ratio, diagnosed with ESRD undergoing HD. Based on The American Society for Parenteral and Enteral Nutrition^s criteria all patients were malnutrition. Two patients experienced PEW and the other had risk of PEW. Medical nutritional therapy is given according to clinical condition of each patient with target protein from 1.1-1.4 g/kgBW/day. Energy and protein intake in two patients was more than 35 kcal/kgBW/day and 1.2 kcal/kgBW/day at first assessment. Unfortunately the others patient intake were low at the first assessment but incresed at the end of monitoring. All patients had low MUAMC scores which indicate muscle depletion. Two patients had increased MUAMC at the end of monitoring.

Keywords: Chronic kidney disease, hemodialysis, medical nutritional therapy, upper arm muscle circumference, protein energy wasting.

Topic: Medical : basic science, clinical, translational research, medical education, and miscellaneous