Impact of hemodialysis on nutritional indices in chronic kidney disease patients: A cross-sectional study in Korle-Bu Teaching Hospital

Abstract

Background: Chronic kidney disease (CKD) is predicted to become the fifth leading cause of global mortalities by 2040. Hemodialysis (HD) is one of the choices for treatment in some countries for CKD patients with end stage renal disease (ESRD). Meanwhile, malnutrition, a well-known CKD-related complication is reported as a non-cardiovascular risk factor associated with mortality in HD patients. Therefore, measures to prevent, screen and manage malnutrition could impact CKD outcomes. Aim: The aim of the study was to assess the impact of hemodialysis on nutritional indices in CKD patients. Methodology: The study was a cross-sectional design that enrolled 177 patients with ESRD patients visiting the HD Unit at the Korle Bu Teaching Hospital (KBTH). Medical records of patients were retrieved and a semi-structured questionnaire was administered to obtain demographic, socio-economic data and lifestyle history. The Patient[1]Generated Subjective Global Assessment (PG-SGA) tool was used to assess the nutritional status of the HD patients. Results: Majority of the study participants 107 (57.1%) were males, whereas 48 (27.1%) were within the ages of 40 – 49 years and 91 (51.4%) had tertiary education. About 87 (49.2%) were on HD for at least 4 years and 138 (78.0%) had two HD sessions weekly. Exactly 72 (40.7%) and 105 (60.5%) reported fatigue and hypertension as the frequent nutritional symptom and the commonest influencing factor to ESRD, respectively. Also, 57.6% of patients had normal weight [BMI (18.5 - 24.49 kg/m2)] and 52.0% were well-nourished. There was a significant negative correlation between BMI and PG-SGA category rating (r = -0.325, p ≤ 0.01) and 53.1% of HD patients needed the highest triaging intervention. Conclusion: Whereas more than half (52.0%) of HD patients were well-nourished, 53.1% required highest-level of triaging intervention. Additionally, fatigue was the frequent nutritional symptom and hypertension was the prevalent predisposing factor among the HD patients. Further studies evaluating malnutrition of HD patients with other nutritional status tools are recommended.