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Dietary records indicate an imbalance in micronutrient status in haemodialysis patients

Published online by Cambridge University Press:  13 May 2013

T. Moffitt ,
P. Garrett  and
M. Hannon-Fletcher
T. Moffitt
Affiliation:
Western Renal Service, Tyrone County Hospital, Omagh and Altnagelvin Area Hospital, Derry/Londonderry
P. Garrett
Affiliation:
Western Renal Service, Tyrone County Hospital, Omagh and Altnagelvin Area Hospital, Derry/Londonderry
M. Hannon-Fletcher
Affiliation:
School of Health Sciences, University of Ulster, Newtownabbey BT37 0QB.
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Abstract

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There is a high prevalence of malnutrition among HD patients due to the restrictive diet, dialysis loses and reduced appetite( Reference Sarnak, Levey and Schoolwerth 1 ). Sub-optimal nutritional status is found to be major risk factors for morbidity and mortality in Haemodialysis (HD) patients( Reference Laville and Fouque 2 ). These factors lead to high levels of oxidative stress in HD patients( Reference Stopper and Treutlein 3 ).

The study aims to analyse food intake and compare recorded dietary intakes to Recommended Nutrient Intakes (RNI) in males and females undergoing HD treatment.

Twelve volunteers were recruited following ethical approval. Four day food diaries were completed (two dialysis and two non-dialysis days) and checked by the renal dietician all data were double entered to WISP (Wisp version 3, Tinuviel Software, Warrington) and exported to SPSS (Statistical Package for the Social Sciences, version 17.00) for statistical analysis.

Macronutrient intakes were unbalanced with a mean protein intake for all HD patients above the RNI and CHO and fat intake lower. The table below details the micronutrients that were below the RNI, of particular significance for females: a reduced folate, vitamin D, iron, selenium and copper with an elevated vitamin C intake. Males had a similar profile however vitamin C and iron were adequate.

Recommended Nutrient Intakes (RNI) HD intake and RNI's were compared using the One- Sample t-test (2 sided): Mean values were significantly different: ***p<0.001; ** p<0.01; * and p<0.05, when compared to RNI.

The imbalance in macronutrient intakes are reflected in the inadequate status of several important micronutrients in this group of HD patients. Given the restricted dietary intake imposed on HD patients this study supports the use of controlled supplementation in an attempt to correct the inadequate vitamin and mineral status and thus improve the levels of oxidative stress and thus improve the antioxidant status of this population.

References

1. Sarnak, MJ, Levey, AS, Schoolwerth, AC et al. (2003) Hypertension 42, 1050–65.Google Scholar
2. Laville, M, Fouque, D (2000) Kidney International 58, 33–9.Google Scholar
3. Stopper, H, Treutlein, A et al. (2008) Nephrol Dial Transplant 23, 3272–3279.Google Scholar
4. Department of Health (1991).Google Scholar