Assessment of the nutritional status of end-stage renal disease patients on maintenance hemodialysis.

We assessed the nutritional status of 50 patients on maintenance hemodialysis by performing anthropometric measurement (pre and post dialytic weight, height, mid-upper arm circumference (MUAC) and related biochemical analysis. The malnutrition score was calculated from the body mass index (BMI), MUAC, hemoglobin, clinical signs of nutritional deficiencies and gastrointestinal manifestations. Stepwise multiple logistic regression analysis was carried out with malnutrition as a dependent variable. There was equal number of men and women in the study with a mean age of 39.5+/-12.1 years. The main cause of renal failure was arterial hypetension (30%), followed by glomerulonephritis (22%). The mean period of hemodialysis was 1.2 +/- 0.9 years. The mean total knowledge score about avoidable food was 2.86+/-1.59 (Total=6) and only 14% have a satisfactory knowledge score. A significant difference between men and women was found in the mean predialytic (52.1+/-9.6 kg) and post dialytic weight (50.0+/-9.7 kg) P< 0.05, while there was insignificant difference in the mean MUAC (22.6+/-3.3 centimeters) and BMI (20.3+/-2.9 kg/meter 2 ). The malnutrition score showed 70% of moderately malnourished patients and 20% severely malnourished. Abnormal biochemical parameters were encountered in the majority of patients. Old age (>/=50 years) was significantly associated with malnutrition. All the patients received only six hours of dialysis a week, which was inadequate dose and had the major impact on the patient's nutritional status. We conclude that poor nutritional status was detected among a significant number of patients with poor dietary knowledge and practices. Increased risk of malnutrition was significantly associated with older age (>/=50 years) and inadequate dialysis dose.