Abstract
Introduction: Malnutrition is a complex, multi-factorial and common problem in patients with end-stage renal disease (ESRD) undergoing hemodialysis that increases morbidity and mortality rate in them. Objectives: To assess the prevalence of malnutrition and associated factors in hemodialysis patients. Patients and Methods: This cross-sectional study was conducted on 239 hemodialysis patients (162 males and 77 females) referred to three dialysis centers in Ahvaz, Iran in 2018. The nutritional statuswas measured using subjective global assessment (SGA)tool. The anthropometric indices, body mass index (BMI) and biochemical parameters including albumin, triglyceride, C-reactive protein (CRP), and adequacy of dialysis (Kt/V) were also measured in all patients. Results: Based on SGA, 45 (18.8%) patients including 32 males and 13 females had mild to moderate malnutrition while 26 (10.9%) patients consisting of 11 men and 15 women had severe malnutrition. We found a significant association between patients’ gender and malnutrition status (P=0.013). In addition, a significant association was seen between age (P=0.024), BMI (P=0.0001), CRP (P=0.047) and serum albumin concentration (P=0.007) with nutritional status. However, we did not find any significant association between triglyceride, Kt/V and duration of hemodialysis per week with malnutrition (P>0.05). Moreover, BMI, patient’s gender and serum albumin were the significant predictors of severe malnutrition in hemodialysis patients (P<0.05). Conclusion: According to high prevalence of malnutrition in ESRD patients undergoing hemodialysis, periodic assessment of nutritional status is necessary for them. Moreover, female patients, CRP, serum albumin and BMI showed a significant correlation with SGA score, which are important to determine the nutritional status of hemodialysis patients (HD) patients.
Highlights
Malnutrition is a complex, multi-factorial and common problem in patients with end-stage renal disease (ESRD) undergoing hemodialysis that increases morbidity and mortality rate in them
Implication for health policy/practice/research/medical education: In a study on 239 hemodialysis patients (Ahvaz, Iran), we found female patients, C-reactive protein, serum albumin and body mass index had a significant correlation with nutritional status
The participants consisted of 239 hemodialysis patients with 57.05 ± 15.58
Summary
Malnutrition is a complex, multi-factorial and common problem in patients with end-stage renal disease (ESRD) undergoing hemodialysis that increases morbidity and mortality rate in them. A significant association was seen between age (P = 0.024), BMI (P = 0.0001), CRP (P = 0.047) and serum albumin concentration (P = 0.007) with nutritional status. BMI, patient’s gender and serum albumin were the significant predictors of severe malnutrition in hemodialysis patients (P < 0.05). Conclusion: According to high prevalence of malnutrition in ESRD patients undergoing hemodialysis, periodic assessment of nutritional status is necessary for them. Female patients, CRP, serum albumin and BMI showed a significant correlation with SGA score, which are important to determine the nutritional status of hemodialysis patients (HD) patients. An important non-cardiovascular risk factor of mortality among hemodialysis patients is malnutrition [7]
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