Dietary assessment of hemodialysis patients in Tehran, Iran

Inadequate dietary intakes are a major determinant of malnutrition in hemodialysis (HD) patients. Considering the lack of information available on dietary intakes of HD patients in Iran, the present study was designed to assess the dietary intakes of HD patients in Tehran, Iran. For this cross-sectional study, from among adult HD patients of 50 Tehran hemodialysis centers, 291 patients were randomly selected. Dietary intakes of these patients were assessed using a 4-day dietary recall. In addition, 4 mL of blood was obtained from each patient before dialysis to measure serum urea, creatinine, albumin, phosphorus, calcium, potassium, and high sensitive C-reactive protein levels. Dietary intakes of energy, protein and fiber were lower than recommended intakes in 88%, 84.5%, and 99% of HD patients, respectively. There were significant associations between dietary energy intake with the patient's age (p < 0.05), and HD vintage (P < 0.001). In addition, a significant association was found between dietary protein intake and sex (P < 0.05). Intakes of vitamins B1, B2, B3, B6, B12, C, E, folic acid, and of the minerals calcium and zinc (from both the diet and supplements) were lower than recommended intakes in 13.5%, 41.5%, 19%, 66%, 61%, 78%, 77%, 24%, 34%, and 98.5% of HD patients, respectively. Inadequate intakes of energy and various nutrients are prevalent in HD patients in Tehran, Iran, which may contribute to increased morbidity and mortality in these patients. Therefore, nutrition counseling and the administration of vitamin and mineral supplements are necessary in Iranian HD patients.