Nutritional Assessment of Patients on Maintenance Haemodialysis Pages with reference to book, From 277 To 279 Haren Kumar, Nilofer Safdar ( The Kidney Centre, Karachi. ) S.A.J. Naqvi ( Department of Nephrourology, Jinnah Postgraduate Medical Centre, Karachi. ) Abstract Nutritional assessment was carried out on fifty haemodialyzed patients by demographic, anthropometric, biochemical and dietary indices. The mean age of the patients was 49 years with a male to female ratio of 2.3:1. The duration of dialysis ranged from 6 to 40 months with a mean of 25 months. Fifty percent of the patients were moderately nourished based on their body weight 44%, body mass index 40% and mid-arm circumference 66%. Seventy percent patients had albumin and total proteins within the normal range. Blood urea nitrogen, creatinine, cholesterol, potassium and phosphorus did not significantly change from the previous reports. The calorie and protein intake in 60- 70% cases was less than recommended. Overall there was a tendency to calorie and to a lesser degree protein malnutrition in our patients. It is suggested that preventing malnutrition by economical, aggressive and ongoing dietary intervention may minimize malnutrition in haemodialyzed patients JPMA 44:277,1994). Introduction Long term maintenance haemodialysis has revolutionalized the care of terminally ill renal failure patients. Presently the emphasis is onim proving the quality of life and rehabilitation 1 . Malnutrition is one of the major risk factors contributing to morbidity and mortality 2 . Most studies on haemodialyzed patients show decreased body weight, skin fold thickness, mid-arm circumference and serum protein concentration 3,4 . Malnutrition in these patients may be attributed to anorexia due to uremic toxins, inter current illnesses, psychological and social factors and due to inadequacy of dialysis procedure it self 5-7 . A nutritional assessment of maintenance haemodialyzed patients was done at The Kidney Centre, Karachi as a part of survey to identify factors contributing to malnutrition. Patients and Methods After informed consent fifty patients of end stage renal disease (ESRD), who were on maintenance haemodialysis for more than 6 months duration at The Kidney Centre were studied, They were on twice a week schedule, each of 4 hours duration on Baxter SPS 450+550 haemodialysis machine using hollow fiber dialyzer. The acetate dialysate in the ratio of 1:34 was prepared from reverse osmosis water treatment plant. The demographic and disease related data was collected through a pretested questionnaire. The impact of financial status on dietary requirements and the degree of compliance was evaluated by socio-economic history and education levels. The type of job and number of working hours of the subjects were determined to find out their quality of life on maintenance haemodialysis. The nutritional assessment was carried out through anthropometric measurements including height, weight and mid-aim circumference (MAC). These parameters were matched with metropolitan height and weight tables for adults; MAC was checked against the international standards, Body Mass Index (BMI) was calculated by the standard formula. BMI of each patient was matched with the acceptable range for males and females 8 . Dietary assessment was done by 24 hours diet recall and food frequency