Dietetic intervention in haemodialysis patients improves malnutrition

Joanne Beer, Emily Mountford, Neil Boudville

Research output: Contribution to journalArticle

Abstract

Objective: Protein-energy malnutrition is an independent predictor of morbidity and mortality in dialysis patients with a prevalence as high as 75%. It is associated with poor dialysis outcomes, including decreased quality of life, increased hospital admissions and increased mortality. We hypothesised that regular dietetic input following evidence-based guidelines would reduce malnutrition and improve patient health. Design and Methods: Two specialist renal dietitians reviewed patients at a single satellite dialysis unit in Perth over a seven-month period in 2015. Demographic, laboratory and malnutrition data using the Subjective Global Assessment (SGA) were collated at baseline and follow-up. One-to-one, individualised dietetic education was given to patients during the seven-month period. Paired t-test and Wilcoxon signed rank tests were used to assess differences between baseline and follow-up results. Results: One hundred and fifty-two patients were recruited. At baseline, mean age was 71.0±12.4 years and 63% were male. Considerable malnutrition was noted at baseline (46%) with mean hand grip strength of 23.7±12.7 kg (<85% of expected value for healthy age-matched individuals). Mean body mass index (BMI) was 27.7±7.0kg/m2, PG-SGA 6.8±4.5 and 25% had a serum albumin ≤35 g/L. The mean time since the patients' last dietetic review was two years, with 25% over three years. Sixty-nine patients were reaudited at the end of the intervention period. Malnutrition rates (SGA ranking), significantly improved falling from 43.5% to 28.9% (p = 0.02). Conclusions: Dietetic intervention in haemodialysis patients reduced rates of malnutrition, underlining the value of dietetic input in this setting.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalRenal Society of Australasia Journal
Volume14
Issue number1
Publication statusPublished - 1 Mar 2018

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