**5. AP in MHD patients**

Of the different types of pneumonia, AP is of particular interest due to its recent increase in occurrence in the aged MHD population. Aged patients are susceptible to dysphagia caused by neurological dysfunctions due to cerebral infarctions, cognitive deficits, and muscle weakness. Since HD patients are susceptible to sarcopenia and malnutrition, these changes increases the risk of development of AP. We recently reported on the clinical characteristics of AP in MHD patients [9]. We surveyed consecutive MHD patients with nosocomial AP who were admitted to our university hospital between April 2007 and December 2008. We deter‐ mined hospitalized MHD patients as a high-risk population for AP, and we revealed that the mortality rate of HD patients with AP was high. We analyzed the risk factors for AP and found that the rate of decline of serum creatinine and albumin levels indicative of the decrease in muscle mass and malnutrition were of predictive value for the contraction of AP. We also found that he AP patients fed via nasal tube feeding or oral intake tended to survive.
