In dialysis patients, decreased appetite, malnutrition, and low activities of daily living (ADL) have been reported as risk factors for mortality. Improving appetite and malnutrition is crucial to reducing mortality in these patients. Individualized blood purification is desirable for this improvement. Regarding physical evaluation of nutritional status, several reports have used InBody (InBody Japan Co., Ltd.) for nutritional assessment, and the skeletal muscle mass index (SMI) calculated using regional muscle mass is used as a diagnostic criterion for sarcopenia. As a biochemical evaluation, nPCR is often calculated, and with a reference range of 0.9-1.1 g/kg/day, values lower than this are associated with an increased risk of mortality. The SGA for comprehensive evaluation has the advantage of being assessable without special equipment. However, since the final nutritional status assessment is subjective to the examiner, care must be taken to ensure appropriate evaluation. Many reports have shown that GNRI is useful for evaluating nutritional status and cardiovascular events in dialysis patients. For these evaluations, if the nutritional status is poor, it is useful not only to purify the dialysis fluid, but also to use an AN69 membrane, a type of polyacrylonitrile membrane that minimizes albumin leakage and adsorbs inflammatory mediators that contribute to MIA syndrome, or to switch to I-HDF, which can suppress albumin leakage compared to online-HDF. To provide better hemodialysis treatment, it is desirable to assess the patient's nutritional status and select blood purification therapy according to that assessment.
