Prevalence of malnutrition and associated factors in hemodialysis patients

Objective To assess the prevalence of malnutrition and associated factors in hemodialysis patients. Methods This is a cross-sectional study of 344 hemodialysis patients from Goiania, Goias aged 18 years or more. The dependent variable, malnutrition, was investigated by the Subjective Global Assessment. The independent variables included socioeconomic, demographic, and lifestyle data, clinical history, and energy and protein intakes. The patients underwent anthropometric measurements and laboratory tests. Multiple Poisson regression determined the associated factors (p<0.05). Results Mild or moderate malnutrition was found in 22.4% of the patients. Malnourished patients had lower body mass index, mid-arm muscle circumference, percentage of body fat, serum creatinine (p<0.001), and normalized protein nitrogen appearance (p=0.001). Multivariate analysis identified the following factors associated with malnutrition: age between 19 and 29 years (PR=1.23, 95% CI=1.06-1.43), family income less than 2 minimum salaries (PR=1.13, 95% CI=1.01-1.27), hemodialysis vintage >= 60 months (PR=1.08, 95% CI=1.01-1.16), Kt/V >= 1.2 (RP=1.12, 95% CI=1.03-1.22), calorie intake <35 kcal/kg/day (PR=1.22, 95% CI=1.10-1.34), and normalized protein nitrogen appearance <1.0 g/kg/day (PR=1.13, 95% CI=1.05-1.21). Conclusion The prevalence of malnutrition in this population was high, corroborating the literature. The prevalence was higher in patients aged less than 29 years and those with low family income, longer hemodialysis vintage, higher Kt/V, and inadequate protein and calorie intakes. Strategies to reverse this situation should include more nutritional care.