Protein-energy wasting risk in end-stage renal disease patients undergoing haemodialysis and patients' adherence to dietary recommendations in Jordan: a cross-sectional study.

Abstract

The primary aim of this study is to evaluate protein-energy wasting in haemodialysis patients and assess their adherence to renal-specific guidelines. An observational cross-sectional study. Patients were recruited from four major governmental hospitals in Amman, Jordan; The University of Jordan Hospital; Al-Hussain Medical Center, Al-Basheer Hospital; and Prince Hamzah Hospital. Data were collected during the period between January 2022 and January 2023. The sample consisted of 344 adult patients who were above the age of 18 years with end-stage renal disease and undergoing haemodialysis. Anthropodermic measurements were performed, and biochemical and dietary data were collected during dialysis sessions. The occurrence of protein-energy wasting, as indicated by a low albumin level (<40 g/L), was 59.6%. The intakes of most of the nutrients were significantly lower than the recommended corresponding values except for fat, where average consumption was significantly higher than the recommended dietary intakes (33.8%, p value=0.000). Mean protein and calorie intakes were associated with serum albumin levels (p value=0.003 and 0.044, respectively). 70% of the study participants revealed that they have rarely or never been spoken to regarding the importance of a renal-specific diet by their healthcare provider. Among study participants, 24% faced a great level of difficulty in following dietary recommendations, and approximately 15% indicated their inability to follow any recommendations. Dietary intake was not adequate according to the dietary guidelines for haemodialysis patients, which could contribute to their low albumin levels and augment the risk of protein-energy wasting. Haemodialysis patients may experience defective nutritional care and a reduced level of commitment to dietary recommendations.