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Nutritional education strategies should be included in a multidisciplinary team for therapeutic education (TPE). We conduct a comprehensive program of therapeutic education for out-center hemodialysis patients. 5 education workshops were performed during dialysis sessions, every 15 days: Illness experience (psychologist), vascular access (nurses), medication management (pharmacist), nutrition management (dietitian) and final evaluation. A specific program of nutrition (EDAM project: Education of the dialysis patient for better food ) was added using 3 specific tools: a companion guide for patients, a game of questions-answers about nutrition(Dialygame) and a guide for the health team to use the tools and conduct nutrition workshops. 64 pts agree to join the program and were compared with a control group of 61 pts who received standard information. Specific questionnaires were created associated with quality of life evaluation (KDQOL) and usual clinical and biological data were noted before and after the 5 sessions as a short-term evaluation. Final results were under evaluation. We present a multidisciplinary TPE program which integrate a specific nutrition TPE and innovative nutrition tools will be shown.

Since 2 years all 265 incident patients in self-dialysis units were included in a prospective study. Every 6-months, clinical and biological nutritional evaluation was associated to a BCM measure. 205 pts have a complete set of data at start (age 60±16 years, BMI 25±5 kg/m2, albumin 37±4 g/L, prealbumin 0.32±0.1 g/L, CRP median 5 mg/L), 135 pts at 6 mo and 56 pts at 2 years. Measures were performed before HD session to ensure stability and reproducibility of body fluid compartments by the same examiner. Lean and fat masses (lean tissue index: LTI, fat tissue index: FTI) were normalized by square body height and compared with a reference range derived from 2000 healthy controls, according to gender and age. 28% of pts had values of LTI below the 10th percentile. A linear correlation exists (p