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Research Detail

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Mousumi Akter
Food and Nutrition Department, Khulna City Corporation Women’s College, (affiliated to Khulna University), Khulna, Bangladesh

Farzana Alam
Assistant Professor
Department of Genetic Engineering and Biotechnology, Jagannath University, Dhaka-1100, Bangladesh

The incidence of renal disease is increasing at an alarming rate in Bangladesh. Malnutrition is directly correlated with the prevalence with these diseases. A total of 120 dialysis patients from both sexes having mean age 45±13. 79 years undergoing hemodialysis were enrolled for the study in Khulna city, Bangladesh. Information regarding disease history and associated co-morbidities were collected from patient’s files. The personal information, prevalent vices, exercise behavior, dietary modifications and clinical and health status of the patients were recorded by using pre-tested questionnaire. Etiology of the chronic renal disease, complications and biochemical parameters were documented from the case files. Renal failure was more prevalent among male than in female. Diabetes mellitus (31.67%) were the most common etiology for chronic renal failure. Pallor of eyes was the most prevailing sign and the most common symptoms are breathlessness (98%), oliguria (88%), anorexia (67%) and nausea (60%). Nutritional status was assessed by anthropometric measurements using body mass index (BMI), mid arm circumference (MAC) and waist-hip ratio (WHR). According to BMI, 43% male are grouped in normal category whereas the majority of females (52%) are underweight with no overweight female respondents. 80% male had low adequacy of energy whereas all the female patients had adequacy of energy, carbohydrate and protein on low level. Dietary data was obtained by using 24-hour dietary recall and food frequency questionnaire. Actual intake of calories, protein, fats and minerals was lower than the recommended intake for hemodialysis patients. More than 50 percent of patient on hemodialysis were at risk of malnutrition. Around 32% of respondents included fruits as per doctor’s advice whereas water and salted foods were restricted to three fourth of patients to protect kidney. Proper assessment of nutritional status, nutritional management and dietary modification can play a central role in preventing malnutrition of hemodialysis patients.
 

  Nutritional status, Dietary modification, Chronic kidney diseases, Hemodialysis
  Khulna city, Bangladesh
  
  
  Food Safety and Security
  Food, Nutrition

To assess the dietary habits and nutritional status of hemodialysis patients, aiming to detect changes of actual daily nutrient intake that they are practicing in respect to normal subjects and then compare with guideline recommendations to assess the prevalence of signs of malnutrition.

Study site:
The study was conducted at the Dialysis unit of Gazi Medical College Hospital, ISK Foundation-Afzalia Estate Kidney Center and Sheikh Abu Nasar Hospital in Khulna City. Among these, Sheikh Abu Nasar Hospital is one of the biggest dialysis centers in Khulna City with 20 HD machines and more than 40 patients can be dialyzed every day in two shifts and Most of the data were collected from that hospitals.

Study period:
The survey was conducted from July to December 2014. Initial months were taken for selection of topic, objective setting, followed by literature review, questionnaire development, pre-testing for data collection, data analysis, data entry and submission of report.

Selection of sample:
Following the Purposive sampling method, one hundred twenty chronic kidney failure patients maintaining Hemodialysis were selected from the dialysis unit of Gazi Medical College Hospital, ISK Foundation and Afzalia Estate Kidney Center and Sheikh Abu Nasar Hospital in Khulna City.

Tools development:
A detailed questionnaire was developed, to raise information on various aspects related to renal patients including demographic profile, clinical and health status, symptoms at the onset of disease, existing signs, etiology of renal disease, medications and supplementations being used, complications seen, lifestyle factors and nutritional profile with respect to anthropometry, dietary intake and biochemical parameters. The questionnaire was structured and modified based on the suggestions of the experts. Further, the developed questionnaire was pre-tested on renal patients at Gazi Medical College Hospital and required changes were made before the final survey has started.

Data collection:
The questionnaire was consisted with three segments. The first part containing information on socio-demographic and economic aspects of chronic renal failure patients included age, gender, education, occupation, monthly income of family, family size, number of earning members, activity pattern of the respondent and marital status was collected by interviewing the respondent. The Clinical and health status of dialysis patients were included in the second part. Information on kidney disease and others disorders, date of commencement of maintenance hemodialysis, medication and supplementation were included in this section. Additionally, Present prevalent vices in subjects such as smoking, betel nut, and tobacco chewing were recorded. Information on exercise habits with special reference to type, regularity, benefits observed and who advised alike were collected. Anthropometric measurements viz., height (cm), weight (kg), waist (cm), hip (cm) and mid-arm circumferences (cm) were recorded as per the guidelines according to WHO criteria. Body Mass Index (BMI) was computed using the formula given by Garrow (1987) to classify the individual as normal, obese or underweight where the abdominal obesity was assessed by waist/hip ratio.

Statistical analysis:
The data were compiled from the questionnaire and fed into the Microsoft excel version 2007 and converted into SPSS-20 for statistical analysis. Descriptive statistics were run to check the distribution of the data and to check for errors that had been made in the data entry.

  Asian J. Med. Biol. Res. 2020, 6 (4), 746-753; doi: 10.3329/ajmbr.v6i4.51242; ISSN 2411-4472 (Print) 2412-5571 (Online)
  www.ebupress.com/journal/ajmbr
Funding Source:
1.   Budget:  
  

From the study it is proved that dialysis does not cure kidney disease, but it can be a life-saving treatment also it greatly improves our quality of life. Through this study it is said that in stable dialysis patients, abnormalities of nutritional parameters are less prevalent than expected by analysis of dietary food intake and that the majority of patients reported a lower than recommended energy and protein intake. Age is the best predictor of energy and protein intake in the dialysis patients who ate less than normal people, but no difference emerged when energy and protein intakes were normalized for body weight. These results recall the attention for individual dietetic counseling in HD patients, and also for a critical re-evaluation of their dietary protein and energy requirements. This study also showed that proper Nutritional education and counseling for patients with renal disease plays a major role in the preservation of renal function and the overall wellbeing of the renal patient.

  Journal
  


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