The Association between Improved Nutritional Care and the Prognosis of Cardiovascular Disease for Hemodialysis Patients

Taiwan hemodialysis (HD) patients were up to 64,269 in 2012 and it still continued to rise 4 percent annually. It costed 40.6 billion health insurance points in 2013 outpatient medical expenses for HD and accounted to 44.8% of outpatient declaration, ranks highest outpatient expenses declaration. It is a huge health-care spending. To establish a complete nutrition care intervention to improve the health of patients and reach the delay duration of deterioration, reduce the medical burden and improve the health insurance structure. Thirty two to 42% HD patients was dead of cardiovascular disease (CVD), improper diet is a serious risk factor for the HD. Diet affect the balance between health and disease states, in order to medical nutrition therapy is necessary. To establish some easy-care skills of nutrition therapy is urgent needs for clinical dietitian. Dietary index is composed of concept of nutrients and foods, to reflect the "quality" and "quantity" of food, and could be developing customized nutritional needs and nutrition knowledge, to prevent, reduce CVD morbidity or disease severity of HD patients. Our research team constructed the "hemodialysis diet assessment index" (HDEI). HDEI could reflect the quality and quantity of diet, and it has a significant correlation between reducing the risk of CVD. This study intends to continue the results of NSC 102-2320-B-038-026- “To improve the nutritional quality of dialysis patients to enhance prognosis”，to modify HDEI scores to get more reflection of the diet composition and more improve HD patients’ CVD risk factors. And to develop HDEI nutrition education package with images based on HDEI to achieve simplification and popularization, and even could be extended to all Taiwan HD patients, to improve the prognosis and medical burden of CVD.