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Status of Nutrition In Hemodialysis Patients Survey (SNIPS): Malnutrition risk by diabetes status
Author(s) -
Boaz Mona,
Azoulay Odile,
KaufmanShriqui Vered,
Weinstein Talia
Publication year - 2021
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14543
Subject(s) - medicine , malnutrition , diabetes mellitus , anthropometry , body mass index , dialysis , hemodialysis , risk factor , logistic regression , serum albumin , endocrinology
Background Increased malnutrition risk has been observed in more than 40% people on haemodialysis in Israel. It is not clear that this risk is homogeneously distributed among people with versus without diabetes. Objectives To examine the influence of diabetes on malnutrition risk among people on haemodialysis. Methods This cross‐sectional study included a representative sample of 375 individuals on haemodialysis treated in hospital dialysis centres throughout Israel. Of these, 126 had diabetes. Dietary intake, biochemistry, anthropometric and hemodynamic measures were recorded. Malnutrition risk categories were defined: “minimal”: body mass index (BMI) ≥23 kg/m2 and serum albumin ≥38 mmol/L; “mild”: BMI <23 kg/m2 and albumin ≥38 mmol/L; “moderate”: BMI ≥23 kg/m2 and albumin <38 mmol/L; “severe”: BMI<23 k/m2 and serum albumin <38 mmol/L. These categories were dichotomized to “minimal” versus elevated malnutrition risk. Results Despite greater BMI, elevated malnutrition risk was identified in 58.8% of individuals with versus 39.3% without diabetes. Adherence to International Society for Renal Nutrition and Metabolism nutrition guidelines was poor regardless of diabetes status. In multivariable logistic regression analysis, diabetes: OR 2.15; C‐reactive protein (nmol/L): OR 1.02; delivered dialysis dose (Kt/V): OR 6.07; and haemoglobin (g/L): OR 0.79, predicted elevated malnutrition risk, even after controlling for age, sex and years on haemodialysis. Discussion Individuals on haemodialysis who have diabetes have elevated malnutrition risk compared to those without diabetes despite greater BMI.