Publication:

Evaluation of nutritional status in chronic kidney disease patients undergoing hemodialysis

Background Kidneys perform the important function of excreting nitrogenous waste products and regulating the volume and composition of body fluids. Malnutrition is common phenomenon in maintenance dialysis patients and risk factor for poor quality of life and increased morbidity and mortality. An association of low albumin levels with increased mortality and morbidity in hemodialysis patients has been hypothesized. Present study aims to go through nutritional status of CKD patients in our institute and their relation to disease or dialysis outcome.

Methods Study is conducted on 100 CKD patients on haemodialysis admitted in various medical wards of the Mc Gann hospital attached to Shimoga institute of medical sciences, Shimoga, Karnataka, India. From August 1st, 2016 to April 30th, 2017 detailed history was taken in all the patients and a thorough physical examination was done. Dietary history was taken and blood is collected for analysis of Hb, blood urea, SR electrolyte, serum calcium, phosphorus, serum albumin, cholesterol, creatinine and CRP. BMI is calculated in all patients.

Results There were 60 males and 40 females. Average age is 46±3.6 years. Most of these patients belong to the age group of 41-50 years (37%). According to WHO BMI classification 55% had BMI between 18.5 to 24.9. 17% less than 18.5.  13% more than 30BMI. Blood urea, serum creatinine was elevated as expected. Mean Hb is 8.21±2.57 gm/dl. Serum albumin is lower mean being 2.66±1.86 gm/dl. CRP elevated 16.5±2.36. low calcium is also seen.

Conclusions The malnutrition in CKD is associated with increased morbidity and mortality rates. Despite the better understanding of the pathophysiologic mechanisms of uremic malnutrition and the improvements made in nutritional support, the nutritional condition of CKD and ESRD patients remains a significant cause for concern. Multimodal therapeutic strategies should be considered. Present study showed elevated prevalence of malnutrition in HD subjects. The nutritional status in patients on HD needs more attention. The role of nutrition in the management of CKD is important and needs to be further researched and newer guidelines are need of the hour.