Malnutrition and hyperphosphatemia in dialysis patients

Abstract

This study aims to document the incidence of hyperphosphatemia in dialysis patients and correlate it with malnutrition. The incidence and severity of malnutrition (low serum albumin) and hyperphosphatemia (increased serum phosphorus level) were correlated with serum calcium, serum alkaline phosphate, and serum parathyroid hormone levels in patients on dialysis. In India, approximately on an average, every 10th person has evidence of early stage of chronic kidney disease. There is high incidence of malnutrition in chronic kidney disease (CKD) patients on dialysis (stage 5D). There have been varying reports of incidence of hyperphosphatemia in dialysis patients in India. Patients on maintenance hemodialysis (MHD) also have high incidence of malnutrition. Indian patients on dialysis have been reported to have less incidence and severity of hyperphosphatemia. A total of 500 patients on MHD (122 female and 378 male patients, age range 9–89 years, and mean age 47.0 ± 15.25 years) were evaluated for hyperphosphatemia, malnutrition, and degree of renal failure. There was trend of more hyperphosphatemia in the group of patients with serum albumin level ≥3.0 g/dl, because these patients were taking adequate dietary protein intake. Patients with malnutrition (serum albumin level <3.0 g/dl) had less incidence and severity of hyperphosphatemia as compared to the group with serum albumin level ≥3.0 g/dl. Chronic kidney disease (CKD) patients on dialysis had high incidence of malnutrition. Hyperphosphatemia was seen even in patients with malnutrition despite lower dietary protein intake and low serum albumin levels.