Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012-2015)

Abstract

Nutrition is an important factor in maintaining good health of hemodialysis (HD) patients, affecting their morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international observational study assessing differences in dialysis practices and outcomes across >20 countries. Here, we present the results for the Gulf Cooperation Council (GCC) countries regarding nutrition data and its relationship with outcomes as a part of the DOPPS Phase 5 study (2012-2015). Data were from Phase 5 of the DOPPS. Main analyses were based on 927 adult chronic HD patients enrolled at the start of the GCC-DOPPS Phase 5 study from each of the 40 randomly selected GCC HD facilities from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Within each participating facility, 20-30 patients were randomly selected, depending on facility size. Analysis showed minor differences across GCC countries in age, albumin levels, nutrition supplement use, and being bothered by the lack of appetite. Elderly (>60 years old) and diabetic HD patients displayed poorer nutritional parameters than young and nondiabetic patients. A low albumin level (<3.2 g/dL) was associated with the highest risk of mortality with a hazard ratio (HR) of 2.47 (P <0.0001) followed by diabetes with HR 1.57 (P <0.04) and older age [HR= 1.27/10 years older (P <0.01)]. Quality of life measures physical component summary and mental component summary correlated negatively with albumin <3.2 g/dL (-2.18 and -5.5, respectively, P <0.05 for each), and with serum creatinine level <7.5 mg/dL (-2.29 and -2.1 respectively, P <0.05 for each. We are presenting the first study of the nutrition status and outcomes for HD patients in the GCC countries in DOPPS. Our results were mostly comparable to findings in previous trials in other countries. Although the data are observational, our study provides good insight into aspects of nutrition in the GCC countries and can be compared to the rest of the world to better understand trends and practice differences.

Relationship Between Nutritional Parameters and Quality of Life in Patients With End-Stage Kidney Disease on In-Centre Haemodialysis in Al-Ahsa, Saudi Arabia

“…This study showed that patients who had normal serum albumin levels had good scores for MCS, BKD, SPKD, and EKD. This result is compatible with other studies that correlated QOL and serum albumin in HD patients [ 15 , 16 , 28 ]. One of these studies was done by Doan et al and revealed that there was a significant correlation between serum albumin level and QOL in 160 patients with HD.…”

“…The study used the KDQOL score to measure QOL and showed that patients with hypoalbuminemia had poorer KDQOL scores [ 16 ]. Another study conducted in Gulf Cooperation Council (GCC) countries showed that low levels of albumin (<3.2 g/dL) were related to high mortality rates and low QOL [ 15 ]. However, a serum albumin level of >3.60 g/dL was associated with decreased rates of mortality [ 28 ].…”

“…Many factors may participate in the protein-energy wasting syndrome in patients with kidney disease, including the presence of inflammation, academia, inadequate diet, and oxidative stress [ 13 , 14 ]. A study conducted in the Gulf Cooperation Council (GCC) countries showed that a low albumin level of <3.2 g/dL was correlated with lower QOL and a high mortality rate [ 15 ]. Another study showed that ESKD patients with hypoalbuminemia and comorbidity had a lower score on the KDQOL questionnaire [ 16 ].…”

Intradialytic Aerobic Exercise in the United Arab Emirates: a Descriptive Study

“…Hyperphosphatemia was highly prevalent in our sample at baseline (75%), a number that was far higher than the 38% reported in the DOPPS-UAE [29], but this can be explained by the fact that the latter results were of data collected in 2013, using a cut-off point for hyperphosphatemia as 6mg/dl. The current study followed the KDIGO 2017 guidelines using tight serum P control ( > 4.6mg/dl) [6].…”

“…We were able to reveal patient characteristics on all study parameters. While existing studies in the region are limited to their descriptive and cross-sectional nature [28,29], or to their short intervention time [30], the current study is unique in its prospective interventional design implementing the IDE program in UAE.…”