Study of the nutritional status of end-stage renal disease patients on maintenance hemodialysis in Benghazi

Abstract

Background: Malnutrition, which is a powerful predictor of morbidity and mortality, is common in patients undergoing hemodialysis. Therefore, adequate nutrition is very important for such patients. Nutritional management in hemodialysis patients is a very important factor for prognosis , a better overall outcome and quality of life.

Objectives: The current study mainly aimed to determine the nutritional status and prevalence of malnutrition and to  investigate the relationship between nutritional markers, anthropometric parameters such as body mass index (BMI), and routine laboratory parameters with SGA  in patients undergoing hemodialysis.

Patients and Methods: A cross-sectional study was carried out on HD patients in Hawari Nephro Center   and Nephro Unit  of Benghazi Medical Center from December 2019 to January 2020. A total of 155 HD patients were recruited for this study and assessed for nutritional status  include both Male and females aged 18 years and over with regular hemodialysis. Outcome measures: Measurements included questionnaire that elicited information on  social demographic characteristics, Patient’s medical history , and duration of hemodialysis. Anthropometry, biochemical parameters were measured. Seven-Point Subjective Global Assessment (7-point SGA) was used to assess the nutritional state of HD patients. Biochemical tests were obtained during the study period from medical files of the studied patients. Data were analyzed using descriptive statistics. The Chi-Square test was applied to examine the study data.

Results: Data shows that  58% of HDP  were well-nourished while the remaining  39%, 3%had mild-to-severe  malnutrition. Regarding the prevalence of  malnutrition in both gender, males group was mor prevalent of malnourished than female group.  SGA  score results indicated some significant  correlations with  patient’s post dialysis BMI and albumin ,however, there was  a negative correlation between demographic characteristics as gender, income, education level, comorbid disease , clinical variable such as duration and frequency of HD and some biochemical tests  as electrolytes, phosphorous ,hemoglobin, cholesterol with SGA scores. In addition,  results  show that  insignificant correlation between nutrients intake, meals pattern of  HD patients  with SGA.

Conclusions: Observations of nutritional status are necessary to maintain the health status of dialysis patients. Every strategy should be used to avoid complications of  hemodialysis  manifested in uremic state including anorexia, nausea, vomiting leading to malnutrition, fluid and electrolyte imbalance leading to volume overload, hyperkalemia, metabolic acidosis, and hyperphosphatemia, as well as abnormalities related to hormonal or systemic dysfunction such as hypertension, anemia, hyperlipidemia, and  bone disease, Timely diagnosis of protein-energy-wasting (PEW) is important for early initiation of nutritional intervention and treatment. In addition, education plans should be prepared to mediate the nutrient intakes and identify the patient's difficulties and provide practical help.