Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index

Abstract

Objectives: This study modified Healthy Eating Index (HEI) based on hemodialysis (HD)-specific nutritional guidelines and investigated associations between the diet quality (DQ) and nutritional risk in HD patients. Methods: The HD-HEI tool adapted the Malaysian Dietary Guidelines 2010 framework according to HD-specific nutrition guidelines. This HD-HEI was applied to 3-day dietary records of 382 HD patients. Relationships between HD-HEI scores and nutritional parameters were tested by partial correlations. Binary logistic regression models adjusted with confounders were used to determine adjusted odds ratio (adjOR) with 95% confidence interval (CI) for nutritional risk based on HD-HEI scores categorization. Results: The total HD-HEI score (51.3 ± 10.2) for this HD patient population was affected by ethnicity (Ptrend <32.6 kg) in men (adjOR 2.38, 95% CI 1.01-5.58, P =.046) but not women. Conclusion: “Poor” DQ was associated with poor nutritional status in Malaysian HD patients, who should be targeted for nutritional counseling.