Use of an appetite and diet assessment tool in the pilot phase of a hemodialysis clinical trial: Mortality and morbidity in hemodialysis study☆
Abstract
An appetite and diet assessment tool (ADAT) was developed for the National Institutes of Health pilot study, Reduction of Morbidity and Mortality in Hemodialysis Patients, to evaluate appetite and factors affecting dietary intake in hemodialysis patients in relation to the dose of dialysis delivered and/or the flux of the dialysis membrane. Forty-seven patients completed the ADAT during baseline (28 men, mean age of 63 years; 19 women, mean age of 61 years), and 31 patients in follow-up (18 men, mean age of 63 years; 13 women, mean age of 60 years). Dietary protein and energy intakes were determined in baseline using diet diary-assisted recalls. The data presented suggest that the ADAT is a practical tool for assessing the relationship between appetite and dietary intake in hemodialysis patients. It may be used in dialysis facilities to evaluate appetite and dietary habits, and to assess the effects of changes in the patient's medical condition that may impact appetite and nutritional status. The effect of delivered dose of dialysis and membrane flux will be assessed during the current full-scale study for possible effects on level of appetite and its correlation with nutritional status, morbidity, and mortality. The full-scale hemodialysis study will provide an opportunity to test the validity and reliability of the ADAT, and its applicability in future clinical trials.
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aDivision of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
bDivision of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA.
cMedical Nutrition Research and Development, Ross Products Division, Abbott Laboratories, Columbus, OH, USA.
dDivision of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA.
eDirector, Frances Stern Nutrition Center, New England Medical Center, Boston, MA, USA.
fProfessor, Tufts University School of Medicine, Boston, MA, USA.
gTufts University School of Nutrition, Boston, MA, USA.
iDepartment of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, OH, USA.
jDivision of Kidney, Urologic, and Hematologic Diseases of the National Institute of Diabetics and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Address reprint requests to HEMO Data Coordinating Center, Department of Biostatistics and Epidemiology, P88, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195.
☆ Supported by the Division of Kidney, Urologic, and Hematologic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health.