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ASSESSMENT OF NUTRITIONAL STATUS IN END STAGE KIDNEY DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS.

ABSTRACT
Background: Malnutrition is a common problem in patients with end-stage-kidney-disease (ESKD) and is a strong risk factor for morbidity and mortality. ESKDis a maladaptive metabolic state and patients need to increase their dietary protein and calorie intake especially when on maintenance dialysis. In a developing country like India, the economic and knowledge barrier affects the diet of the patient. In this study we assessed the prevalence of malnutrition and the impact of dietary counselling on improvement in nutritional status of the patient. Method: This study enrolled patients undergoing maintenance hemodialysis in our centre between June 2017 and June 2019. The prevalence of malnutrition was assessed by Subjective Global Assessment (SGA). Dietary history was recorded with a 24-hour dietary recall method. The patient was then periodically counselled regarding adequate dietary protein and calorie requirement and was re-assessed for the prevalence of malnutrition at the end of 6 months. Results: The mean age of study cohort was 38.76±10.85 years and 64 % were male.Hypertension (38.89%) and Diabetes (11.11%) were the most common co-morbid illnesses.The prevalence of PEW was 92% at baseline and 86% at the end of 6 months of follow up. There was a significant increase in BMI from 19.97 to 20.38 (p=0.022). Most of the study patients were from very low socioeconomic status (78% Class V modified Prasad's scale). Conclusions: There is a very high prevalence of protein-energy malnutrition among ESKD patients on maintenance haemodialysis. Nutritional counselling resulted in statistically significant improvement in the prevalence of malnutrition. Hence,nutritional counselling must be given regularly to patients with kidney disease.