Indicators of Nutritional Health of Patients on Haemodialysis

BACKGROUND:
This project describes indicators of health risk of patients requiring haemodialysis and their adherence to current renal-specific nutrient guidelines and indicators of overall healthy eating.

METHODS:
The current study analysed nutritional intakes reported by a single-day 24-h recall by patients undergoing haemodialysis in an outpatient centre. Participants (n = 37) were clients of a 12-chair unit, based in South Brisbane, Australia. Information on patient characteristics and cardiovascular and health risk were collected from patient charts. Nutritional intakes were compared to references provided by the KDOQI Clinical Practice Guideline, Nutrient Reference Values and/or general healthy eating guidelines.

RESULTS:
Approximately half of the patients had lipid levels indicating cardiovascular risk, 40% had BMIs in the obese category, and 20% were assessed as malnourished. Patients met, on average, 80% of their energy and 106% of protein requirements. When using renal-specific guidelines, this population met recommendations for sodium, but not fibre. Using guidelines for the general population, this population consumed too much energy from saturated fat. Phosphorus, calcium and potassium appeared to be below the nutrient reference values. Most patients reported consuming two or more vegetables per day while few met the recommendations for fruit, fish and legumes.

CONCLUSIONS:
The intakes of this cohort suggested compliance with traditional renal-specific dietary advice, but perhaps at the expense of an overall healthy diet. Dietitians who work with patients requiring haemodialysis may choose to prioritize general healthy eating advice, such as that based on the Mediterranean Diet, to better support this patient population.