A multi-technique analysis of the nutritional status and quality of life of patients on maintenance Hemodialysis (MHD)

Award winning abstract submitted at the AICNU 2014 in Bangalore.

Authors

  • Daphnee D K*
  • Rajalakshmi P*
  • Silvia Sargunam C*
  • Balasubramaniam R**
  • Dr. Bhuvaneshwari*

Department of *Dietetics, **Statistics, Apollo Hospitals, Greams Road, Chennai

Background

Malnutrition is common in chronic hemodialysis patients and is associated with poorer quality of life (QOL) when the degree of malnutrition becomes severe increasing the morbidity and mortality.

Aim

This study aims to assess and correlate the nutritional status of patients undergoing MHD with QOL.

Methods

A prospective-observational study conducted in our outpatient Hemodialysis unit with random sampling. A team of Clinical Dietitians collected the details of demographic, modified subjective global assessment (SGA), anthropometric, clinical measures and QOL using SF- 8 were gathered through interviews using a questionnaire specifically developed for this purpose. We included End Stage Renal disease patients who were on MHD atleast twice a week and who gave consent. Statistical analysis using Pearson correlation, Fisher’s exact test, Chi-Square test were used.

Results

A total of 60 patients (50% males), aged 53.5±15.7 years were included. SGA revealed 42(70%) as moderately malnourished. Based on total lymphocyte count 37(62%) were found to be mild to severely malnourished and using body mass index classification 37% males and 40% females were obese. There was a significant difference in the nutritional status between the sex using triceps skin fold thickness (TSF) (p=0.000), mid arm muscle circumference (MAMC) (p=0.002), mid arm muscle area (MAMA) (p=0.000). Depleted somatic protein and fat stores were found in males and females respectively. The SGA score had a negative correlation with MAC, MAMC, TSF, MAMA and a positive correlation was found between the somatic and visceral protein stores. The usual energy intake had a significant effect on the nutritional status (p=0.019). SGA correlated significantly with each variables of QOL (p<0.005). Emotional stability and social engagement was significantly higher in males (p<0.005).

Conclusion

Above mentioned multi-technique analysis can be used to identify patients who require more attention due to the risk of malnutrition. Regular monitoring/counselling by the qualified Clinical Dietitian will help in the improvement of nutritional status and better QOL.