Regular analysis of the nutritional intake of hemodialysis patients is important to maintain optimal nutritional status. At the start of hemodialysis treatment, protein requirements increase, while phosphate, potassium and sodium restrictions are still recommended to prevent metabolic complications. The aim of the research was to determine whether there are differences in dietary intake between patients with poor and good nutritional status and whether dietary intake is sufficient according to recommendations. The clinical study was conducted in the hemodialysis center of the University clinical center in Ljubljana. The research was conducted in two parts. First, we measured the body composition of 170 hemodialysis patients and assessed their nutritional status in terms of malnutrition and inflammation using the MIS (Malnutrition Inflammation Score) questionnaire. We then selected 28 patients with the lowest and highest MIS score and conducted a nutritional interview and assessed their physical fitness. We were interested in protein, phosphorus and potassium intake, as protein-energy malnutrition, hyperphosphatemia and hyperkalemia are often present in this population. Between the groups of patients with poor and good nutritional status, there are statistically significant differences in the dietary intake of all studied parameters (macronutrients, micronutrients – P, K, Ca, Na; intake of salt, fiber, fruit and vegetables). The average intake of energy and protein in both groups is insufficient according to the recommended values. There is no correlation between dietary phosphorus intake and blood serum phosphorus or between dietary potassium intake and blood serum potassium. The results of bioimpedance measurements, nutritional analysis and low serum albumin values confirm the presence of protein-energy malnutrition. Hemodialysis patients urgently need nutritional counseling, because without it they cannot achieve the nutritional goals necessary to support the treatment.
|
