Predictors of malnutrition in Australian haemodialysis patients and comparison of dietary protein intakes to national guidelines
Renal Society of Australasia
Faculty of Health, Engineering and Science
School of Exercise and Health Sciences
Background: Malnutrition is an important concern for patients undergoing dialysis therapy. We aimed to investigate predictors of nutritional status in a population of in-centre Western Australian haemodialysis (HD) patients and compare dietary protein intakes to national guidelines of 1.2-1.4 g/kg body weight/day.Method: Dietary intakes were assessed by diet history interview for 35 in-centre patients receiving HD (mean age 65.2 ± 13.1 years; median dialysis vintage 3 [IQR 22] months). Patient Generated Subjective Global Assessment was used to classify patients as well-nourished or malnourished. Patient characteristics, co-morbidities and dialysis vintage were investigated along with biochemical data. Logistic regression was used to determine which factors were independent predictors of malnutrition.Results: Out of the 35 patients, 54% (n=19) were classified as well-nourished with 46% (n=16) malnourished. Increased body mass index, protein intake and albumin were independently associated with lower odds of malnutrition. A mean protein intake of 1.05 ± 0.33 g/kg/d was observed in the well-nourished group compared with 0.86 ± 0.28 g/kg/d for the malnourished group. Only one patient in each group (malnourished and well-nourished) was within the recommended protein intake guidelines (1.2-1.4 g/kg/d).Conclusion: Malnutrition remains a problem for HD patients, and dietary protein intake is an important predictor. However, our findings suggest that patients may be well-nourished at protein intakes lower than the current Australian guidelines. Further research investigating the application of the international protein intake guidelines of 1.1-1.2 g/kg/d for maintenance of nutritional status in clinically stable dialysis patients in Australia may be useful.