Diet quality in patients with end‐stage kidney disease undergoing dialysis

Abstract

SUMMARY Background People on haemodialysis (HD) are at risk of consuming a poor quality diet. This includes inadequate intake of omega‐3 long chain polyunsaturated fatty acids (n‐3 LCPUFA). Objective This study aims to investigate diet quality, with a particular focus on n‐3 LCPUFA intake, in a population of incentre HD patients. Design Dietary intake was measured using three 24 hour recalls; the Polyunsaturated food frequency questionnaire (PUFA FFQ) and the Total Diet Score (TDS). Dietary intake was also compared to evidence based practice guidelines (EBPG). Nutritional status was assessed using the Patient Generated Subjective Global Assessment (PG SGA). Subjects A total of 32 dialysis patients were recruited, from two regional HD centres in New South Wales, Australia. Main Outcome Measure Diet quality was the main outcome measure. Results Diet quality of study participants was poor, with the majority not meeting the EBPG for energy, protein and potassium. All participants exceeded the recommended amount of saturated fat. The mean TDS of the dialysis cohort was 10.2, which was significantly higher than the TDS of 9.3 of a healthy disease free cohort (p < 0.05). Positive correlations were found between TDS and LC omega‐3 intake (r = 0.392) and TDS and total omega‐6 intake (r = 0.363). Only 22% of participants met the suggested dietary target for n‐3 LCPUFA intake. Conclusion Dialysis patients in this study had suboptimal diet quality. Improvements are required for better adherence to the EBPG. Increased consumption of n‐3 LCPUFA fatty acids may also be of benefit.

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

“…Poor diet quality has been reported in other HD populations [44] and has not consistently been associated with malnutrition. In a study comparing dietary and nutrition status measures in HD patients by time on dialysis, investigators found increased energy and protein intake over time despite deteriorated measures of somatic protein [45].…”

Blood Fatty Acid Status and Clinical Outcomes in Dialysis Patients: A Systematic Review

“…An increase in oxidative stress and inflammation could induce membrane lipid peroxidation, and PUFAs containing double bonds are more susceptible to attack by free radicals [ 83 ]. (iii) Uremic anorexia in CKD patients causes poor oral intake [ 84 ] and, therefore, suboptimal consumption of dietary PUFA [ 85 ], which subsequently leads to deficiency in essential FAs. (iv) Inadequate fish consumption as plasma and erythrocyte n -3 PUFA levels were reported as reflections of the frequency of fish consumption in HD patients [ 40 ].…”

Impact of Intensive Dietary Counseling on Serum Albumin in Haemodialysis Patients with Chronic Liver Disease

“…This biological nutritional marker seems to be in a strong indirect correlation to mSGA in all four groups (group I r = -0.614, p=0.001; group II r = -0.531, p=0.001; group III r = -0.424, p=0.005; respectively group IV r =-0.679, p=0.002), which indicates the lower the albumin, the more severe the malnutrition score. There are studies in HD patients that have demonstrated a potential relationship between malnutrition and hypoalbuminemia, both depending on poor nutrition but also on microinflammatory state [11,12]. Indeed it was reported that a majority of uremic patients undergoing hemodialysis suffer from nutritional disorders [13].…”