BackgroundProtein-energy wasting (PEW) is a relatively prevalent problem among adult haemodialysis patients (HDP). PEW is an important determinant of morbidity and mortality in HDP, therefore it is essential for dietitians to accurately assess malnutrition (MN) in these patients. HDP appear to be more susceptible to developing MN; however, this is not well documented. Therefore this study aimed to assess the nutritional status among HDP and to establish the factors associated with MN in these patients.MethodsA cross-sectional survey was carried out in Nablus, northern West Bank, in the main haemodialysis (HD) centre at the An-Najah National University Hospital. MN was detected using the malnutrition-inflammation scale (MIS), which involved four major elements: the patient’s related medical history, their body mass index, a physical examination and laboratory parameters.ResultsA total of 174 patients (91 male) were included in the study. Patients were aged 57.7 ± 12.8 years, and the median dialysis vintage was 3 years (interquartile range 1–5 years). HDP, especially the elderly (unstandardized coefficient β, 1.728; 95% CI, 0.700 to 2.756; P = 0.001), those with multiple comorbid diseases (unstandardized coefficient β, 1.673; 95% CI, 0.556 to 2.789; P = 0.004); those taking multiple chronic medications (unstandardized coefficient β, 1.259; 95% CI, 0.197 to 2.321; P = 0.020), or those with a long dialysis vintage (unstandardized coefficient β, 1.449; 95% CI, 0.410 to 2.487; P = 0.007), were positively associated with the MIS score in a multivariable linear regression model. Furthermore, HDP living with their family were negatively associated with the MIS score (unstandardized coefficient β, − 2.545; 95% CI, − 4.738 to − 0.352; P = 0.023).ConclusionsThe MIS score results indicate that MN is prevalent among HDP. These results demonstrate some correlations between nutritional status and patient characteristics (i.e. clinical and sociodemographic factors). Therefore these findings should help to increase the awareness of healthcare providers for interventions to enhance the nutritional status of HDP, especially those who are elderly, have multiple comorbid diseases, have multiple chronic medications, have experienced a long dialysis vintage or who live alone.Electronic supplementary materialThe online version of this article (10.1186/s12882-019-1288-z) contains supplementary material, which is available to authorized users.

Background: Patients on hemodialysis (HD) commonly suffer from poor sleep quality which in turn compromises their quality of life and well as their mortality risk according to many studies. In Palestine however, no single study had emphasized the association and prevalence of sleep quality and daytime sleepiness among hemodialysis patients (HDP). Therefore, we conducted this study to determine the relationship between regular HD and the situation regarding sleep quality and daytime sleepiness in HDP. Methods: In this cross-sectional survey, we targeted HDP at one HD center in An-Najah National University Hospital. Sleep problems were assessed by both the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), which are considered as standardized tools for the assessment of sleep quality and daytime sleepiness, respectively. Results: Of the 192 dialysis patients who were interviewed, 167 were included in the final analysis of this study, with a response rate of 87%. The mean age of the participants was 57.6 ± 12.9. Fifty-two percent were males, and an equal percentage of the participants were 60 years old or older. The median ESS of the participants was 7 [4-11] and 43.1% of the participants had 9 or more ESS score, indicating excessive daytime sleepiness. The median PSQI score was 8 [6-12] and 76.65% of the participants scored more than 5 points on the PSQI, indicating poor sleep quality. Neither the ESS score nor the PSQI score were significantly associated with any particular category of participants, based on their demographic or clinical characteristics. Conclusions: In conclusion, we found that dialysis patients had poor sleep quality, evident by their high median PSQI score, though their excessive daytime sleepiness was less evident by their median ESS score in the high normal values. Additionally, we found a high prevalence of poor sleep quality among HDP, whereas excessive daytime sleepiness was less prevalent. Finally, no significant association was found between either of the two scores and the participants' demographic or clinical characteristics surveyed in this study.