Evaluation of nutritional status of patients on haemodialysis

Abstract

Objective: To evaluate the nutritional status of patients on haemodialysis for chronic renal failure.

Design: Single center cross-sectional hospital based study.

Place and duration of study: This study was carried out at haemodialysis unit of Shaikh Zayed Hospital, Lahore from March to May 2000.

Patients and methods: Fifty-one patients on regular haemodialysis were included in the study. Nutritional status was checked by laboratory data (hemoglobin, hematocrit, blood urea nitrogen, serum albumin, total protein, and lipid profile), anthropometric measurements (height, dry weight, body mass index (BMI), mid arm circumference (MAC), triceps skin fold thickness (TSF) and mid arm muscle circumference (MAMC)) and symptoms.

Results: The total number of patients was 51. Twenty-four patients were male and 27 female. Mean age was 43 years. Majority of the patients, 27 (53%), was between 21 to 50 years of age. Major cause of end-stage renal disease was chronic glomerulonephritis in 19 (35%) patients followed by diabetic nephropathy 14 (27%) and hypertensive nephropathy in 11 (21%). Hemoglobin and hematocrit was normal only in 7 patients and rest of the 44 patients were anemic. Serum albumin was 3.64+/-0.59 gm/dl (Mean +/- SD), total protein 7+/-0.86 gm/dl, serum calcium 9.5+/-0.7 mg/dl, serum phosphorus 4.8+/-0.5 mg/dl, serum cholesterol 170+/-43.56 mg/dl,LDL 96.94+/-40.76 mg/dl, HDL 45.7+/-19.61 gm/dl, serum triglyceride 176.8+/-99 gm/dl. Adequacy of dialysis, urea reduction ratio (URR) was adequate only in 16(31%) and rest of the patients 35(69%) were getting inadequate amount of dialysis. On anthropometric measurements, majority of the patients was malnourished and in moderate to severe category of malnutrition. Symptoms of uremia (nausea, vomiting, body aches, pain and pulmonary oedema) were more in patients who were getting inadequate dialysis i.e. urea reduction ratio more than 70% (p-value<0.05).

Conclusion: Majority of patients was anaemic, undernourished and factors responsible for the same were economical, late referral to nephrologist, inappropriate dietary restrictions and inadequate dialysis.