LB005 FUNCTIONING IN PATIENTS ON HOME PARENTERAL NUTRITION

Clinical Nutrition 1 LB005 FUNCTIONING IN PATIENTS ON HOME PARENTERAL NUTRITION P. Thul1 , M. Mueller2 , E. Grill2 , A. Weimann3 , G. Stucki2 . 1 Poliklinik f¨ ur Allgemein- und Viszeralchirurgie, Charit´ e Campus Stadtmitte Humboldt-Universit¨ at, Berlin, 2 Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Munich, 3 Klinik f¨ ur Allgemein- und Viszeralchirurgie, Klinikum St. Georg, Leipzig, Germany Rationale: A primary objective of Home Parenteral Nutrition (HPN) is to prevent malnutrition in patients with terminal disease such as advanced cancer. While the effect on survival is still not clear, HPN arguably improves functioning and quality of life. Thus patients’ experiences concerning functioning and quality of life need to be considered when deciding on the provision of HPN. Currently used quality of life measures hardly reflect patients’ perspectives and experiences. The objective of our study was to investigate patients’ perspectives on functioning and health in relation to HPN. Specific aims were to identify both the relevant aspects of functioning and health in patients undergoing HPN and the patients’ experiences on improvement in functioning and health due to HPN. Methods: We conducted a series of qualitative semistructured interviews. The interviews were analysed to identify categories of the International Classification of Functioning, Disability and Health (ICF) addressed by patients’ statements. Patients were consecutively included in the study until an additional patient did not yield any new information. Results: We conducted 16 interviews. Ten of 16 participants were female, age ranged from 33 to 83 years. The diagnoses included were gastric (n = 4), colorectal (6), liver (2), ovarian (1), breast (1) and mouth (1) cancer. We extracted 94 different ICF-categories representing patient-relevant aspects of functioning and health (32 categories from the ICF component “Body Functions”, 10 from “Body Structures”, 32 from “Activities & Participation”, 18 from “Environmental Factors”). Patients referred to 22 different aspects of functioning improving due to HPN, namely activities of daily living, mobility, sleep and emotional functions. Conclusions: Aspects of functioning and health both patient-relevant and improving due to HPN could be identified. Consequently, further studies should consider those aspects to measure quality of life and functioning. References WHO (2001) International Classification of Functioning, Disability and Health: ICF. Kvale (1996) Interviews An Introduction to Qualitative Research Interviewing. Sage Publications. Cieza et al. (2005) ICF linking rules: an update based on lessons learned. J Rehabil Med 37(4): 212. Disclosure of Interest: M. Mueller, TravaCare GmbH, Grant/ Research Support

209 LB006 RELATION OF BODY COMPOSITION AND NUTRITIONAL INTAKE IN MAINTENANCE HEMODIALYSIS (MHD) PATIENTS S. Dusilova-Sulkova1 , V. Blaha1 , M. Kadlec1 , V. Pavlik2 , T. Halajcuk2 , E. Mistrik1 , P. Moucka1 , L. Sobotka1 . 1 Department of gerontology and metabolism, University Hospital, 2 Department of military hygiene, University of defense, Hradec Kralove, Czech Republic Rationale: Malnutrition in hemodialysis patients is common and is associated with increased morbidity, mortality and impaired quality of life. To evaluate whether inflammatory status or impaired food intake relate to nutritional status of MHD patients, we examined the prevalence of inadequate nutritional intake and its relation to body composition in MHD. Methods: Bioimpedance biospectroscopy (BCM monitor, Fresenius Medical Care, Bad Homburg, Germany) was used to evaluate the body composition (lean tissue index LTI, fat tissue index FTI, kg/m2 ) in clinically stable MHD patients (N = 33, 16 male, 17 female, mean age 66.4 years, mean duration of hemodialysis 40 months). Three days supervised food recordings were used to assess nutritional intake using NutriDan software (Danone Institut, Czech Republic). Results: Both energy and protein intake was lower than European Best Practice Guidelines recommendations (Nephrol Dial Transplant, 2007). Daily protein intake correlated significantly with phosphorus intake (r = 0.87, p < 0.001), which exceeded recommended value (mean 1313 mg/day) despite low protein intake, pointing out to one of nutritional paradoxes in this patient population. LTI (*age and sex dependent) correlated significantly with protein intake (r = 0.48, p < 0.01), but not with FTI. On the other hand, only borderline correlation was found between CRP (11.9 + 12.07 mg/l) and LTI (r = 0.26). Measurement Recommendation Pts in (mean+SD) rangea Energy intake (kJ/kg) Protein intake (kJ/kg) LTI (kg/m2 ) BMI (kg/m2 ) a Patients

91.3+30.4 0.84+0.24 11.1+2.65 29.8+0.24

135 1.1 <10 critical* >23

12 24 44 94

in recommended range (%).

Conclusions: Body composition monitor represents a useful and simple bedside tool for assessment of nutritional status in MHD patients. Lean tissue index was low in nearly half of clinically stable dialysis patients and was related to insufficient nutritional intake rather than to inflammatory status, which deserves more intensive attention for nutritional counseling. Supported by research projects IGA MH CR NR/9259 3, MSM 0021620820, MSM 0021620819. Disclosure of Interest: none declared