Renal Nutrition-Related Knowledge, Dietary Compliance and Malnutrition among Hemodialysis Patients in Lebanon

Abstract

Introduction: Patients with end stage kidney disease (ESKD) on hemodialysis should follow a strict diet during the interdialytic period. Compliance to treatment, including diet, is key for optimal disease management and health outcomes and to protect against malnutrition. The objective of this study was to assess the relationship between renal nutrition-related knowledge, renal dietary guidelines, compliance to treatment and risk of malnutrition among patients with ESKD in Lebanon. Methods: A convenience sample of 119 patients with ESKD was collected from the dialysis units of the Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH) and Hammoud Hospital University Medical Center (HHUMC). Demographic characteristics, anthropometric measurements, bioelectrical impedance tests, biochemical data, nutrition knowledge and compliance were collected from the participants or from their medical charts. Results: 100 of the 119 participants were found to have malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Weight loss was the most common phenotypic criterion among malnourished patients, while severe weight loss was significantly associated with poor compliance. Additionally, people with poor compliance tended to be younger (<55 years of age) and with lower levels of income and education (p<0.05) Conclusion and Recommendations: Malnutrition rates are alarmingly high among patients with ESKD in our sample and are significantly associated with poor treatment and dietary compliance. Future studies with a larger more representative cohort are required to confirm our results. Accordingly, intervention trials targeting compliance among ESKD patients in Lebanon are warranted to prevent malnutrition and to achieve better clinical outcomes.