Assessment of nutritional status, dietary intake and adherence to dietary recommendations in hemodialysis patients

Abstract

Assessing dietary habits and nutritional status in patients with end stage kidney disease (ESKD) treated with maintenance hemodialysis (HD) plays a crucial role in the prevention of protein energy malnutrition. The aim of this study was, on one hand, to assess nutritional status and dietary intake of HD patients in comparison with the guidelines recommendations and, on the other hand, to determine the characteristics of those who didn’t meet their nutritional needs. In a sample of 156 HD patients (70 women and 86 men), clinical data, anthropometric measurements and two 24 hour dietary recalls were collected to evaluate the nutritional status and dietary intake. The results showed that based on the Body Mass Index (BMI), appropriate nutritional status was reported for only 60.6% of the patients. The mean energy intake was 1904.98 ±592.50 kcal per day, only 16.8% of participants were found compliant regarding the recommended intake of energy density; about 33 % met the recommended minimum of 1.2g/kg of protein per day and only 36.5% have adequate fiber consumption. The protein and energy density were negatively correlated with age, BMI and waist circumference. No patients achieved the recommendations concerning the saturated fat intake. In conclusion, the study data report that a high proportion of dialysis patients did not meet current renal specific dietary requirements and that the diet quality is considered poor. These results call the attention to individual dietetic counseling and promotion of a global dietary approach in hemodialysis patients in order to improve clinical outcomes and the quality of life of chronic kidney patients.