Association between dietary intake and nutritional status in Eastern Mediterranean patients receiving hemodialysis

Abstract

BACKGROUND: Studies on hemodialysis (HD) patients reveal suboptimal dietary intakes, which have been linked to protein-energy wasting and its detrimental consequences. OBJECTIVE: Given the paucity of data regarding nutrient intakes of Eastern Mediterranean HD patients, we conducted a pilot study on HD patients at Heraklion, Crete, Greece to assess adequacy of dietary intakes and to determine their relationship with nutritional status. METHODS: Nutritional status of 36 patients aged 61.8±15.0 years was evaluated by three 24-hour dietary recalls, anthropometry and blood biochemical markers. RESULTS: The mean dietary energy and protein intakes were 34.4±2.1 kcal/kg and 1.25±0.067 g/kg, respectively. The anthropometric results were indicative of a well-maintained somatic status. 30.6% of the patients had adequate weight (BMI 18.5-24.9 kg/m2) and 69.4% were overweight or obese (BMI≥25 kg/m2). Patients had arm anthropometrics higher than the 25th percentile. Mean predialysis serum levels of urea and creatinine, were within the expected range, phosphorus was borderline high, while albumin and cholesterol were at the optimum level for HD patients. In univariate linear regression, a positive relation was observed between ideal weight-adjusted energy (wEI) and protein (wPI) intakes with anthropometric and biochemical indices. However, in the multivariate model, only the associations between dietary intakes of energy and protein with anthropometric indices remained significant. CONCLUSIONS: 24-hour derived-dietary intakes reached recommended targets and adequately reflected the nutritional status of the patients, according to anthropometric and biochemical indices. Additionally, the 24-hour recall method should be part of the routine care for HD patients, in order to identify patients at nutritional risk before objective parameters of wasting are documented. © 2020 - IOS Press and the authors. All rights reserved.