Effects of Dietary Protein Restriction on Nutritional Status of Hemodialysis Patients

Abstract

Haemodialysis is one of the three renal replacement therapies in which waste products and excess fluid are removed from blood when kidneys stop functioning properly. Protein catabolism is increased as patients lose some protein during haemodialysis treatment. Sufficient protein intake is of great significance, yet prevalence of inadequate protein consumption persists due to various reasons, resulting protein-energy malnutrition (PEM). The studies regarding low protein intake among haemodialysis patients is lower compared to studies conducted on non-dialysis chronic kidney disease (CKD) patients. The purpose of this study was to investigate the prevalence of protein restriction practices and its effect in nutritional status of haemodialysis patients. The study was descriptive exploratory analysis among 150 haemodialysis patients at one of the largest dialysis center of Kathmandu district using anthropometric, biochemical, clinical and dietary (ABCD) assessments. Among 150 haemodialysis patients, majority (63.3%) were male. 71.3% were undergoing haemodialysis for more than 1 to 5 years and 82.7% doing twice a week in- center haemodialysis. According to serum albumin report, 66.7% were identified as PEM. Body mass index (BMI) result also classified 3.3% as underweight. It was concluded that the effect of protein restriction resulted as malnourished among certain patients. The underlying causes for consuming low protein diets were associated with dislike to protein-rich foods, financial constraints, lack of awareness, and other factors. Establishing regular consultations with dieticians and closely monitoring dietary patterns appeared as crucial approaches for enhancing the nutritional status of these patients. It is essential to acknowledge that protein requirements vary based on different stages of CKD and the presence of concurrent health conditions. Consistent follow-up by a multidisciplinary team, utilizing a range of nutrition assessment methods specified for haemodialysis patients is vital step.