Study of Nutritional Status and Gastrointestinal Health in Patients Undergoing Hemodialysis and their Association with Laboratory Parameters and Dialysis Adequacy in Semnan, Iran

Abstract

Background: Malnutrition is a common problem, which may exacerbate gastrointestinal symptoms, reduce treatment efficiency, and deteriorate hemodynamic stability in hemodialysis (HD) patients. Objectives: This study aimed to investigate nutritional status and gastrointestinal health in HD patients and to determine the association of these variables with laboratory parameters and dialysis adequacy in Semnan, Iran in 2016. Methods: Thiscrosssectionalstudywasconductedon80patientswithaminimum6-monthhistoryof HD.Gastrointestinalhealth andnutritionalstatuswereassessedusinggastrointestinalsymptomratingscaleandsubjectiveglobalassessment,respectively. The laboratory parameters included alkaline phosphatase, urea, creatinine, albumin, iron, hemoglobin, hematocrit, and blood sugar. Results: Overall,27.5% of thepatientshadmildtomoderatemalnutrition,while72.5% hadagoodnutritionalstatus. Themostcom-mondigestiveproblemwasconstipation(83.7%). Calciumintake(r=0.2313; P=0.046), creatinine(r=0.234; P=0.041), andalkaline phosphatase (r = 0.414; P< 0.001) showed a positive correlation with gastrointestinal health. In addition, alkaline phosphatase (r = 0.419; P < 0.001) had a positive relationship with nutrition. HD adequacy was > 0.8 in 15% and ≥ 1.20 in 11.3% of the patients. HD adequacy ( r = 0.260; P = 0.023), urea nitrogen (r = 0.228, P = 0.046), and creatinine (r = 0.330; P = 0.003) had a positive correlation with gastrointestinalhealth. Overall, there was asignificant positive correlation betweennutrition and gastrointestinalhealth (r = 0.799; P < 0.001). Conclusions: The present findings can facilitate better planning to improve nutritional status, gastrointestinal health, laboratory parameters, and dialysis adequacy in the management of HD patients, particularly those with malnutrition.