Ekenci kd. assesment of relationship between nutritional status and sociodemograhic characteristics in patients with end-stage renal failure in hemodialysis

This study was carried out to evaluate the relation between sociodemographic characteristics and nutritional status in the patients who were receiving hemodialysis treatment because of chronic kidney failure. The study was conducted on total 128 patients (between the ages 23 and 85) including 57 male and 71 female patients receiving dialysis treatment at least six months at three different private dialysis center between April 2017 and May 2017. The patients who accepted to be involved in the study filled out a questionnaire form including disease and personal information during the face to face interview. Food consumptions of the patients for three days (one dialysis day and two normal days) were recorded. Anthropometric measurements (height, dry body weight, triceps skinfold thickness, mid-upper arm circumference, mid-upper arm muscle circumference, calf circumference, handgrip strength) and body composition analysis by BIA were record. Blood values were taken from patient's file. ''Subjective Global Assesment'' (SGA),'' Nutrition Risk Screening ''(NRS-2002) and ''Malnutrition Inflammation Score'' (MIS) tests were performed to evaluate malnutrition status of the patients. The average age of the patients involved in the study was 59.9±13.06 years. Body mass indexes of the male and female patients were 23.7±4.46 kg/m² and 25.6±5.01 kg/m² respectively. According to SGA, it was found out that 8.6 % of the patients excessively malnourished, 15.6 % of the patients who experienced moderate malnourishment and 75.8 % of the patients well-nourished. According to NRS-2002, it was found out that 21.9 % of patients have the risk of developing undernutrition. MIS values of male and female patients were determined 5 and 6 points, respectively (p>0.05). According to NRS-2002, 64.2% of patients that were at risk of malnutrition had primary and lower level education. According to SGA, 50% of the patients with mild to moderate malnutrition had primary and lower level education, 45.5% of the patients with excessively malnourished were literate, and 36.4% were primary school graduates. There was a significant difference between the education levels of the patients and the results of NRS-2002 and SGA(p<0.05). There was a negative correlation between MIS score and BKI, fat percentage, lean body mass, total body water, triceps skinfold thickness, mid-upper arm circumference, mid-upper arm muscle circumference, calf circumference, handgrip strength, and serum albümin level in male and female patients (p<0.05). There was positive correlations between MIS with SGA and NRS 2002 in all patients (p<0.05). However, there is no correlation between MIS with educational attainment and level of income (p>0.05). According to SGA and NRS-2002, anthropometric measurements included BKI, mid-upper arm circumference, mid upper arm muscle circumference, calf circumference, handgrip strength; serum albümin level from biochemical parameters are lower in malnourished patients however MIS was higher in patients with malnutrition (p<0.05). As a result of the study, including SGA, MIS, NRS-2002, anthropometric measurements and biochemical parameters with more than one method should be used assesment of nutritional status in hemodialysis patients. However, further studies are required to determine nutritional status in hemodialysis patients for different age and gender groups. Key words: Hemodialysis, nutritional status, malnutrition, sociodemographic characteristics