Study of Nutritional Status and Gastrointestinal Health in Patients Undergoing Hemodialysis and their Association with Laboratory Parameters and Dialysis Adequacy in Semnan, Iran

Background Malnutrition is a common problem, which may exacerbate gastrointestinal symptoms, reduce treatment efficiency, and deteriorate hemodynamic stability in hemodialysis (HD) patients. Objectives This study aimed to investigate nutritional status and gastrointestinal health in HD patients and to determine the association of these variables with laboratory parameters and dialysis adequacy in Semnan, Iran in 2016. Methods This cross sectional study was conducted on 80 patients with a minimum 6-month history of HD. Gastrointestinal health and nutritional status were assessed using gastrointestinal symptom rating scale and subjective global assessment, respectively. The laboratory parameters included alkaline phosphatase, urea, creatinine, albumin, iron, hemoglobin, hematocrit, and blood sugar. Results Overall, 27.5% of the patients had mild to moderate malnutrition, while 72.5% had a good nutritional status. The most common digestive problem was constipation (83.7%). Calcium intake ( r = 0.2313; P = 0.046), creatinine (r = 0.234; P = 0.041), and alkaline phosphatase (r = 0.414; P< 0.001) showed a positive correlation with gastrointestinal health. In addition, alkaline phosphatase (r = 0.419; P < 0.001) had a positive relationship with nutrition. HD adequacy was > 0.8 in 15% and ≥ 1.20 in 11.3% of the patients. HD adequacy ( r = 0.260; P = 0.023), urea nitrogen (r = 0.228, P = 0.046), and creatinine (r = 0.330; P = 0.003) had a positive correlation with gastrointestinal health. Overall, there was a significant positive correlation between nutrition and gastrointestinal health (r = 0.799; P < 0.001). Conclusions The present findings can facilitate better planning to improve nutritional status, gastrointestinal health, laboratory parameters, and dialysis adequacy in the management of HD patients, particularly those with malnutrition.