Evaluation of nutritional status in chronic kidney disease patients undergoing hemodialysis


  • Nagabhushana S. Department of General Medicine, Shimoga Institute of Medical Science (SIMS), Shimoga, Karnataka, India
  • Ranganatha M. Department of General Medicine, Shimoga Institute of Medical Science (SIMS), Shimoga, Karnataka, India
  • Ranjith Kumar G. K. Department of General Medicine, Shimoga Institute of Medical Science (SIMS), Shimoga, Karnataka, India
  • . Virupakshappa Department of General Medicine, Shimoga Institute of Medical Science (SIMS), Shimoga, Karnataka, India




CKD, Dietary advice, Haemodialysis, Malnutrition, Serum albumin


Background: Kidneys perform the important function of excreting nitrogenous waste products and regulating the volume and composition of body fluids. Malnutrition is common phenomenon in maintenance dialysis patients and risk factor for poor quality of life and increased morbidity and mortality. An association of low albumin levels with increased mortality and morbidity in hemodialysis patients has been hypothesized. Present study aims to go through nutritional status of CKD patients in our institute and their relation to disease or dialysis outcome.

Methods: Study is conducted on 100 CKD patients on haemodialysis admitted in various medical wards of the Mc Gann hospital attached to Shimoga institute of medical sciences, Shimoga, Karnataka, India. From August 1st, 2016 to April 30th, 2017 detailed history was taken in all the patients and a thorough physical examination was done. Dietary history was taken and blood is collected for analysis of Hb, blood urea, SR electrolyte, serum calcium, phosphorus, serum albumin, cholesterol, creatinine and CRP. BMI is calculated in all patients.

Results: There were 60 males and 40 females. Average age is 46±3.6 years. Most of these patients belong to the age group of 41-50 years (37%). According to WHO BMI classification 55% had BMI between 18.5 to 24.9. 17% less than 18.5.  13% more than 30BMI. Blood urea, serum creatinine was elevated as expected. Mean Hb is 8.21±2.57 gm/dl. Serum albumin is lower mean being 2.66±1.86 gm/dl. CRP elevated 16.5±2.36. low calcium is also seen.

Conclusions: The malnutrition in CKD is associated with increased morbidity and mortality rates. Despite the better understanding of the pathophysiologic mechanisms of uremic malnutrition and the improvements made in nutritional support, the nutritional condition of CKD and ESRD patients remains a significant cause for concern. Multimodal therapeutic strategies should be considered. Present study showed elevated prevalence of malnutrition in HD subjects. The nutritional status in patients on HD needs more attention. The role of nutrition in the management of CKD is important and needs to be further researched and newer guidelines are need of the hour.


Author Biography

Nagabhushana S., Department of General Medicine, Shimoga Institute of Medical Science (SIMS), Shimoga, Karnataka, India






Goddard J, Turner AN, Stewart LH. Chronic kidney disease. Principles Practice Med. 2010;21:487-93.

National kidney foundation. Clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2000;35:S1-140.

Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. AMJ Kidney Dis. 2003;42:864-81.

Marckmann. Nutritional status and mortality of patients in regular dialysis therapy. J Int Med. 1989;226:429-32.

Lowrie EG, Huang WH, Lew NL. Death risk predictors among peritoneal dialysis and hemodialysis patients: a preliminary comparison. Am J Kidney Dis. 1995;26:220-8.

Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcomes, Canada-USA (CANUSA) peritoneal dialysis study group. J Am Soc Nephrol. 1996;7(2):198-207.

Stenvikel P, Barany P, Chung SH, Lindholm B, Heimburger O. A comparative analysis of nutritional parameters as predictors of outcome in male and female ESRD patients. Nephrol Dial Transplant. 2002:17(7):1266-74.

De Araujo IC, Kamimura MA, Draibe SA, Canziani ME, Manfredi SR, Avesani CM, et al. Nutritional parameters and mortality in incident hemodialysi patients. J Ren Nutr. 2006;16(1):27-35.

El-Sayead AS, Ahmed AM, Mahmoud MA. Nutritional status and malnutrition prevalence among maintenance hemodialysis patients. IOSR JNHS. 2015;4(4):1940-2320.

Hajira B, Samiullah M, Chawla RK. Nutritional status assessment of hemodialysis patients at Rehman medical institute Peshawar. APRN J Agricultural Biological Sci. 2013;8(4):329-36.

Adithya BR, Sangeeta S, Sunanda V, Priya SH, Prakash G. A study on biochemical parameters of malnutrition in chronic kidney disease patients undergoing hemodialysis. J Evolution Medi Denta Sci. 2015;4(84):14721-5.

Mafra D, Farage NE, Azevedo DL, Viana GG, Mattos JP, Velarde LG, et al. Impact of serum albumin and body-mass index on survival in hemodialysis patients. Int Urol Nephrol. 2007;39(2):619-24.

Fleischmann E, Teal N, Dudley J, May W, Bower JD, Salahudeen AK. Influence of excess weight on mortality and hospital stay in 1346 hemodialysis patients. Kidney Int. 1999;55:1560-7.

Azar AT, Wahba K, Mohamed AS, Massoud WA. Association between dialysis dose improvement and nutritional status among hemodialysis patients. Am J Nephrol. 2007;27:113-9.

Alvarez-ude F, Fernandez-reyes MJ, Sanchez R, Mon C, Iglesias P, Vazquez A. Nutritional status, comorbidity and inflammation in hemodialysis. Nephrol (MADR). 2000;20:540-9.






Original Research Articles