Bee S.Y1, Hing M.L1, Winnie C.2, Harvinder G.S2
1Bachelor of Science (Hons) Nutrition and Dietetics, International Medical University (IMU), Kuala Lumpur.
2Department of Nutrition and Dietetics, International Medical University (IMU), Kuala Lumpur.
The purpose of this study is to describe the body composition and dietary intake of haemodialysis patients with protein energy wasting (PEW) at IMU Dialysis Center, Kuala Lumpur.
This is a cross-sectional study carried out at IMU Dialysis Center on 36 haemodialysis patients. Sociodemographic, medical history, medication, biochemical and haemodialysis profile were obtained via interview and clinical record. Body composition analysis was measured using BIA and sarcopenia assessment was done using handgrip strength (HGS) and relative appendicular muscle mass index (RASMI). The dietary-intake was recorded using a three-day dietary recall method via interview for three consecutive days consist of dialysis day, non-dialysis day and weekend. PEW assessment was done using the International Society of Renal Nutrition and Metabolism (ISNRM) diagnostic criteria. Data analysis were conducted using IBM SPSS Statistic version 22.0.
Results & Discussion
The patients had a mean duration of HD of 3.5±3.2 years and mean age of 52±12 years. The prevalence of sarcopenia was 65.7% (n=22) based on HGS and overall PEW prevalence was 36.1% (n=13). The body composition result showed a significant difference in fat mass (p=0.038), fat mass index (p=0.05) and post dialysis BMI (p=0.047) comparing PEW and non-PEW groups. About 6 (8.3%) patients had Dietary Energy Intake (DEI) of 30-35kcal/kg. Patients with PEW had mean DEI of 20.4 ± 6.2kcal/kg/day, which is below the recommended intake and DPI of 0.8 ± 0.3g/kg/day that were barely at the baseline of recommended intake. Due to accumulation of uremic toxins may render the patient suffering from anorexia and poor appetite further impairing the oral intake. Thus, impacting the body composition reflects a lower yield compared to the non-PEW cohort.
Patients with PEW will require urgent attention for dietary intervention to improve nutritional status. Hence, future research is needed to examine the body composition and dietary intakes of renal patients on haemodialysis.