Protein-energy wasting risk in end-stage renal disease patients undergoing haemodialysis and patients' adherence to dietary recommendations in Jordan: a cross-sectional study.

Objectives: The primary aim of this study is to evaluate protein-energy wasting in haemodialysis patients and assess their adherence to renal-specific guidelines.

Design: An observational cross-sectional study.

Setting: Patients were recruited from four major governmental hospitals in Amman, Jordan; The University of Jordan Hospital; Al-Hussain Medical Center, Al-Basheer Hospital; and Prince Hamzah Hospital. Data were collected during the period between January 2022 and January 2023.

Participants: The sample consisted of 344 adult patients who were above the age of 18 years with end-stage renal disease and undergoing haemodialysis.

Outcome Measures: Anthropodermic measurements were performed, and biochemical and dietary data were collected during dialysis sessions.

Results: The occurrence of protein-energy wasting, as indicated by a low albumin level (<40 g/L), was 59.6%. The intakes of most of the nutrients were significantly lower than the recommended corresponding values except for fat, where average consumption was significantly higher than the recommended dietary intakes (33.8%, p value=0.000). Mean protein and calorie intakes were associated with serum albumin levels (p value=0.003 and 0.044, respectively). 70% of the study participants revealed that they have rarely or never been spoken to regarding the importance of a renal-specific diet by their healthcare provider. Among study participants, 24% faced a great level of difficulty in following dietary recommendations, and approximately 15% indicated their inability to follow any recommendations.

Conclusion: Dietary intake was not adequate according to the dietary guidelines for haemodialysis patients, which could contribute to their low albumin levels and augment the risk of protein-energy wasting. Haemodialysis patients may experience defective nutritional care and a reduced level of commitment to dietary recommendations.