Evaluation of nutritional status and its associated factors in hemodialysis patients

Background & Aims: Restriction of some nutrients, loss of nutrients through dialysis, and anorexia are the most critical factors affecting nutritional status in hemodialysis patients. This study aimed to determine the nutritional status and its associated factors in hemodialysis patients.
Methods: This cross-sectional study was performed on 220 hemodialysis patients who had been on dialysis for at least three months. The nutritional status was measured using three criteria: subjective global assessment (SGA), protein-energy wasting (PEW), and obesity criteria. Other nutritional indicators, such as food intake assessments, anthropometric measurements, and bioelectrical impedance analysis (BIA) were also applied.
Results: The prevalence of protein-energy wasting was 78.2% (95% CI 72.74-83.66), and 22.7% (CI 95% 17.16-28.24) based on SGA (mild malnutrition) and PEW, respectively. The prevalence of obesity was 77.3% (CI 95% 71.76-82.84). According to PEW, about 18.8% of obese people (n = 64) were malnourished. Quality of life was not correlated with any criteria; SGA, PEW, and obesity. Protein (kcal / day) and energy (kcal / day) had a negative correlation with obesity (r = -0.81 and p = 0.042 r = -0.094 and p = 0.089, respectively).
Conclusion: The prevalence of protein-energy malnutrition and obesity in hemodialysis patients in Urmia can differ according to the criteria that we choose to assess nutritional status. A relatively large population of hemodialysis patients studied has a nutritional deficiency, necessitating the need for nutritional counseling in these patients.

背景与目的：限制某些营养素的摄入、透析过程中营养素的流失以及厌食是影响血液透析患者营养状况最为关键的因素。本研究旨在确定血液透析患者的营养状况及其相关因素。研究方法：本研究为一项横断面研究，对至少接受三个月透析的220名血液透析患者进行了调查。营养状况的评估采用三项标准：主观整体评估（SGA）、蛋白质-能量消耗（PEW）以及肥胖标准。此外，还应用了其他营养指标，如食物摄入评估、人体测量学和生物电阻抗分析（BIA）。研究结果：蛋白质-能量消耗的患病率为78.2%（95% CI 72.74-83.66），基于SGA（轻度营养不良）和PEW的患病率分别为22.7%（CI 95% 17.16-28.24）。肥胖的患病率为77.3%（CI 95% 71.76-82.84）。根据PEW，约18.8%的肥胖患者（n = 64）存在营养不良。生活质量与任何标准（SGA、PEW和肥胖）均无相关性；蛋白质（千卡/天）和能量（千卡/天）与肥胖呈负相关（r = -0.81，p = 0.042；r = -0.094，p = 0.089）。结论：乌尔米亚地区血液透析患者的蛋白质-能量营养不良和肥胖的患病率可能因所选择的营养状况评估标准而异。研究显示，相当大比例的血液透析患者存在营养不良，这迫切需要对这些患者进行营养咨询。