Relationship of gastrointestinal symptoms with nutritional status and biochemical parameters in hemodialysis patients

In this study, relationships between nutritional status and biochemical parameters of gastrointestinal (GI) symptoms in patients receiving hemodialysis (HD) treatment were investigated. The study samples consisted of 88 HD patients who were being treated at the Dialysis Unit of Bandirma State Hospital. To assess nutritional status of patients in the study, the height of tall, dry body weight, waist circumference, mid- arm circumference (MAC), triceps skinfold (TSF) thickness, as anthropometric measurements were measured. In addition, 3-day food consumption records, Subjective Global Assessment - Dialysis Malnutrition Score (SGA - DMS), Malnutrition Inflammation Score (MIS) were used. For biochemical parameters, blood analysis results, recorded in the patient files were used. The GI symptoms were determined using the Gastrointestinal Symptom Rating Scale (GSRS). When the nutritional status of the patients was examined, 34 (38.6%) and 46 (52.3%) were found to be mild / moderate malnutrition according to SGA-DMS, and MIS, respectively. Anthropometric measurements of the patients were found to be statistically significant with both SGA - DMS and MIS (p <0.05). In particular, it was found that MAC values had very high correlation with MIS scores (p<0.001). A statistically significant correlation was found between creatinine, albumin and uric acid values of biochemical parameters of patients and both SGD - DMS and MIS scores (p <0.05). Total protein values were found to be significant only with MIS score (p <0.05). In addition, statistical significance was found between creatinine and albumin values and MIS scores (p <0.001). According to the GSRS, indigestion was taken place firstly, between GI symptoms in the HD patients who participated to the study, the second was constipation. Statistical significance was found between the symptoms of abdominal pain in HD patients and both SGD - DMS and MIS scores (p<0.001). In addition, there was statistically significant difference between the total GSRS score and SGA - DMS at p <0.05 level. Some biochemical parameters (serum albumin, sodium and calcium) were also found to be significantly correlated with GI symptoms (p <0.05). A statistically significant relationship was found between the mean of vitamin E with diet and abdominal pain symptom (p<0,05). At the and of the thesis study, it was determined that malnutrition rate was very high in HD patients and this was related to GI symptoms. Increased malnutrition scores were found to be correlated with increased GI symptom severity. It was also thought that decreasing the vitamin E level taken with diet may be related to the increase in the severity of abdominal pain symptoms. In this respect, anthropometric measurements, biochemical parameters, scoring methods reflecting nutritional status, and evaluation of different markers of HD patients, such as GI symptoms will contribute to the treatment of HD patients.