Nutrition-related cardiovascular risk factors in hemodialysis patients

Abstract

Objective: This study sought to determine nutrition-related cardiovascular risk factors in hemodialysis patients.

Design: This was a cross-sectional study.

Setting: This study included outpatients from the Hemodialysis Unit of Baskent University Ankara Hospital.

Patients: This study was conducted on 93 endstage chronic renal-failure patients (50 male and 43 female) aged between 18 and 65 years. Patients undergoing hemodialysis three times weekly with 4 hours of standardized bicarbonate hemodialysis were included. Patients with cardiovascular disease were excluded.

Main outcome measure: A questionnaire was administered to patients regarding demographic and disease information. The nutritional status of patients was determined by a food-frequency questionnaire, a 3-day, 24-hour dietary record, and subjective global assessment. Several biochemical parameters were analyzed, and body weight was measured.

Results: Percentages of patients' serum total cholesterol, low-density lipoprotein cholesterol, triglyceride, and total cholesterol/low-density lipoprotein cholesterol levels that were higher than National Kidney Foundation (NKF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) criteria amounted to 7.5%, 4.3%, 43%, and 10.8%, respectively. The percentage of patients' serum high-density lipoprotein cholesterol levels that were lower than NKF and NCEP/ATP III criteria reached 41.9%. According to serum albumin levels, 44.1% of patients were malnourished. In terms of patients' dietary total fat intake, 98.9% were higher than NKF and NCEP/ATP III criteria, and all patients' dietary saturated fatty acids intake were higher than recommended. For 87.1% of patients, the dietary polyunsaturated fatty acids/saturated fatty acids ratio was <1. Moreover, in terms of NKF recommendations, the percentages of patients with insufficient dietary folate and vitamin B(12) intake reached 100% and 61.3%, respectively.

Conclusion: Hemodialysis patients should be considered at high risk for developing cardiovascular disease. Therefore, when planning diets of endstage renal disease patients, it is important to consider nutrition-related cardiovascular-disease risk factors for the sake of quality of life and survival.