It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calroie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis, which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon -rank sums test, Scheffe test, Kruskal -Wallis test and Pearson correlation coefficients. The results are following; 1. There was no significant difference in the calorie and proten intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index, triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea mtrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine incresed significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However, each of biochmical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status mearsured with protein and calroie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

PURPOSE: The purpose of this study was to explore the effects of hand reflexology on the physiological?emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. METHOD: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. RESULT: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR and BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell and CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. CONCLUSION: We have found that the hand reflexology helps the chronic patients to improve physiological emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.