Nutrition-Related Cardiovascular Risk Factors in Hemodialysis Patients
published online 12 October 2009.
Objective
This study sought to determine nutrition-related cardiovascular risk factors in hemodialysis patients.
Design
This was a cross-sectional study.
Setting
This study included outpatients from the Hemodialysis Unit of Baskent University Ankara Hospital.
Patients
This study was conducted on 93 endstage chronic renal-failure patients (50 male and 43 female) aged between 18 and 65 years. Patients undergoing hemodialysis three times weekly with 4 hours of standardized bicarbonate hemodialysis were included. Patients with cardiovascular disease were excluded.
Main Outcome Measure
A questionnaire was administered to patients regarding demographic and disease information. The nutritional status of patients was determined by a food-frequency questionnaire, a 3-day, 24-hour dietary record, and subjective global assessment. Several biochemical parameters were analyzed, and body weight was measured.
Results
Percentages of patients' serum total cholesterol, low-density lipoprotein cholesterol, triglyceride, and total cholesterol/low-density lipoprotein cholesterol levels that were higher than National Kidney Foundation (NKF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) criteria amounted to 7.5%, 4.3%, 43%, and 10.8%, respectively. The percentage of patients' serum high-density lipoprotein cholesterol levels that were lower than NKF and NCEP/ATP III criteria reached 41.9%. According to serum albumin levels, 44.1% of patients were malnourished. In terms of patients' dietary total fat intake, 98.9% were higher than NKF and NCEP/ATP III criteria, and all patients' dietary saturated fatty acids intake were higher than recommended. For 87.1% of patients, the dietary polyunsaturated fatty acids/saturated fatty acids ratio was <1. Moreover, in terms of NKF recommendations, the percentages of patients with insufficient dietary folate and vitamin B12 intake reached 100% and 61.3%, respectively.
Conclusion
Hemodialysis patients should be considered at high risk for developing cardiovascular disease. Therefore, when planning diets of endstage renal disease patients, it is important to consider nutrition-related cardiovascular-disease risk factors for the sake of quality of life and survival.
Department of Nutrition and Dietetics, Health Sciences Faculty, Baskent University, Ankara, Turkey
Address reprint requests to Gul Kiziltan, PhD, Department of Nutrition and Dietetics, Health Sciences Faculty, Baskent University, Baglica Kampusu, Eskisehir Yolu 20.km, 06530 Ankara, Turkey.
ABSTRACT