Adherence to Caloric and Protein Recommendations in Older Hemodialysis Patients: A Multicenter Study

Nutrients. 2022 Oct 7;14(19):4160. doi: 10.3390/nu14194160.

Abstract

Hemodialysis (HD) patients are characterized by malnutrition, which adversely affects their survival. The development of malnutrition is influenced, among other factors, by improper diet and the advanced age of patients. The study aimed to assess the nutritional status and adherence to dietary recommendations among older patients. The multicenter study included 179 stable HD patients. The nutritional status was assessed by a 7-point Subjective Global Assessment (SGA). Anthropometry and body composition was analyzed. The diet was assessed based on the 3-day food diary and the Food Frequency Questionnaire with 6 answers (FFQ-6). Blood laboratory tests were performed. Based on the 7-point SGA, malnutrition was diagnosed in 38.5% of HD patients. The decreased content of the muscle tissue (LTI < 14 kg/m2) was observed in 70.4% of the examined patients and the decreased concentration of s-albumin was observed in 44.1% of patients. Older patients had significantly lower LTI. 26% of patients consumed less than 25 kcal/kg body weight and less than 0.8 g protein/kg body weight. Older patients’ diets contained significantly fewer calories. There were significant differences between nutrient intake on a weekday with dialysis, a weekday without dialysis, and a weekend day without dialysis. The lowest intake of nutrients was observed on the day of dialysis. Nutritional education and the determination of whether food is permitted during hemodialysis are necessary to improve patients’ nutrition.

Keywords: chronic kidney disease; dietary assessment; hemodialysis; malnutrition; nutritional status.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Albumins
  • Body Weight
  • GTP-Binding Proteins
  • Humans
  • Kidney Failure, Chronic* / therapy
  • Malnutrition* / diagnosis
  • Nutrition Assessment
  • Nutritional Status*
  • Patient Compliance*
  • Renal Dialysis*

Substances

  • Albumins
  • GTP-Binding Proteins

Grants and funding

This research received no external funding.