The impact of nutritional status on health-related quality of life in hemodialysis patients

Abstract

Malnutrition is frequent in hemodialysis (HD) patients. Nutritional deficiencies may negatively impact quality of life (QOL). This study examines the utility of the Malnutrition-Inflammation Score (MIS) in detecting nutritional risk (NR) and assesses the correlation between nutritional status and QOL in dialysis patients upon starting a nutritional intervention program (NIP). One hundred and twenty patients were included in this cross-sectional study. The MIS was used to detect NR and the Kidney Disease Quality of Life (KDQOL-SF) instrument version 1.2 was used to assess QOL. 62% of patients were found to be at NR (MIS > 5). Nutritional status was significantly correlated with all generic QOL sub-scales. On a multiple linear regression analysis, malnutrition showed the highest level of explanation in the Kidney Disease Summary Component which explained 28.9% of the variance; the Physical Component Summary which explained 33% of the variance; and the Mental Component Summary which explained 21.5% of the variance. Malnutrition was found to be the most significant predictor of impaired scores on the KDQOL-SF. The use of MIS to identify patients at NR and a nutritional assessment to detect malnutrition in its early stages are important given the effects a NIP can have on improving QOL in HD patients.

The Correlation of Interleukin-6, Malnutrition Inflammation Score and Asymmetric Dimethylarginine in Chronic Kidney Disease Patients Undergoing Routine Hemodialysis

“…This results are similar to the study by Kalantar-Zadeh et al on 83 hemodialysis CKD patients in San Fransico and 378 hemodialysis CKD patients in Los Angeles, with the average MIS of 8.3 ± 4.2 and 6.3 ± 3.9, respectively [10], [13]. A study by Visideo et al also obtained an average result of MIS of 8.4 ± 3.5 [31]. Routine hemodialysis has a risk of malnutrition due to the catabolism effect of kidney replacement therapy, decreased appetite due to uremic conditions and nutritional restrictions that cause inadequate dietary intake, loss of nutrients through dialysis membranes, inflammation, and metabolic acidosis.…”

“…Routine hemodialysis has a risk of malnutrition due to the catabolism effect of kidney replacement therapy, decreased appetite due to uremic conditions and nutritional restrictions that cause inadequate dietary intake, loss of nutrients through dialysis membranes, inflammation, and metabolic acidosis. These factors can cause hemodialysis CKD patients experience a malnutrition energy protein syndrome [31]. High MIS values are associated with poor nutritional status, high inflammation, mortality rate, and morbidity in hemodialysis CKD patients [11], [31], [32].…”

“…These factors can cause hemodialysis CKD patients experience a malnutrition energy protein syndrome [31]. High MIS values are associated with poor nutritional status, high inflammation, mortality rate, and morbidity in hemodialysis CKD patients [11], [31], [32].…”

Factors associated with the prevalence of malnutrition among adult hemodialytic patients: A two-center study in the Jeddah region, Saudi Arabia

“…[ 1 ] Renal replacement therapies, which include peritoneal dialysis, hemodialysis (HD), and kidney transplants, were globally established in the 1960s. [ 2 ] In 2018, the total number of chronic HD patients in Saudi Arabia was 19,033, including 6419 patients in the Western region, an increase of 58.6% from the number of cases in the 2011 (around 12,000 cases). Saudi Arabia has 271 HD centers, most working under the supervision of the Saudi Ministry of Health (MOH), except several government non-MOH hospitals.…”

“…[ 4 ] Furthermore, albumin levels are significantly related to the nPCR. [ 2 , 7 ] Finally, bioelectrical impedance analysis is a noninvasive and inexpensive method for assessing body composition in clinical conditions in terms of lean body mass, fat percent, and fluid volume. Different factors can affect bioelectrical impedance measurements, including age, sex, and ethnicity.…”