Nutritional Challenges in Hemodialysis: A Perspective from Albania

Advanced kidney disease and renal replacement therapy are associated with numerous metabolic and nutritional imbalances. Nutrition plays a major role in reducing complications and improving quality of life. The aim of this structured narrative review was to explore the specific nutritional and fluid management challenges among hemodialysis patients in Albania. A search of various databases (PubMed, Cochrane Library, Medscape, UpToDate, and Google Scholar) was conducted for publications from 2000 to 2025, identifying 49 studies for inclusion. Evidence from the literature indicates that patients undergoing hemodialysis present with multiple vitamin and mineral deficiencies. Common issues include vitamin C, vitamin D, B6, B12, carnitine deficiency, and malnutrition prevalence of 43%-61% across various studies. In Albania, care is constrained by low household incomes; traditional diets high in phosphorus, potassium, and salt; the absence of renal dietitians; inconsistent patient and family education; and excessive interdialytic weight gain. Recommendations emphasize the need to implement routine measurements of biochemical markers such as serum prealbumin, anthropometric measurements such as body mass index and mid-upper arm circumference, evaluation of dietary intake at least every 3 months and objective monitoring tools such as bioimpedance spectroscopy for assessing extracellular volume status. The lack of official data on the nutritional status of hemodialysis patients in Albania highlights the urgent need for multicenter, collaborative research, and the establishment of improved, evidence-based nutritional regimens. Implementing these clinical and policy measures is crucial for significantly enhancing patient outcomes and enabling dialysis care in Albania to approach global standards. Cite this article as: Pina P, Prifti E, Nasto F, Shella M, Shtӫmbari X, Kaca S. Nutritional challenges in hemodialysis: a perspective from Albania. Eurasian J Med. 2026;58(4):1196, doi: 10.5152/ eurasianjmed.2026.251196.