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Assessment of Nutrition Status of Dialysis Patients in Rwanda
Date Issued
2018-04-16
Author(s)
Marcella Canelo
University of Global Health Equity
Abstract
Introduction: Chronic Kidney Disease is a condition that affects individuals worldwide and
Rwanda is no exception. Malnutrition is a significant issue among dialysis patients and
dramatically increases risk of morbidity and mortality. Dialysis patients also often have
abnormal potassium, phosphorus, calcium and albumin laboratory values. The problem is that
the overall nutritional status of stage 5 chronic kidney disease patients on dialysis in Rwanda is
unknown and the objective of this study was to determine the nutrition status of a cohort of
patients on dialysis with Stage 5 CKD at select facilities in Kigali and Gisenyi.
Methods: In this cross-sectional study, adults who had been on hemodialysis for more than 30
days were recruited from dialysis centers in Kigali and Gisenyi. Nutrition status was measured
by performing a physical exam and interview known as the Subjective Global Assessment (SGA),
calculating body mass index (BMI), and collecting laboratory values for potassium, phosphorus,
calcium and albumin. SGA scores categorized participants into A (nourished), B (moderately
malnourished) or C (severely malnourished). BMI was categorized as underweight (<22 kg/m2),
normal/overweight (22-29.9 kg/m2), and obese (>30. kg/m2). Laboratory values were
categorized as high, normal or low.
Results: 34 patients were assessed 19 (59.4%) of whom were males and 13 (40.6%) were
females. Mean age for all was 52.4 years. 28% of participants were classified as moderately
malnourished (SGA B) and 62.4% of participants were underweight (BMI <22 kg/m2). There was
a correlation (p =0.0117) between moderate malnutrition and underweight. 69% of participants
presented with high potassium (> 5.10meq/l, mean value 5.49 mEq/L), while the majority of
participants were normal for phosphorus, calcium and albumin. There was no association
between low albumin and moderate malnutrition (p=0.0687) and low albumin and underweight
(p=0.6834).
Conclusion: Malnutrition is prevalent among hemodialysis patients in Rwanda and there may
be an increased risk of morbidity and mortality among patients due to low BMI scores. When
creating nutrition recommendations for hemodialysis patients, potassium restriction should be
emphasized. Additional research could help to draw further conclusions around malnutrition,
laboratory values and dialysis in the region.
Rwanda is no exception. Malnutrition is a significant issue among dialysis patients and
dramatically increases risk of morbidity and mortality. Dialysis patients also often have
abnormal potassium, phosphorus, calcium and albumin laboratory values. The problem is that
the overall nutritional status of stage 5 chronic kidney disease patients on dialysis in Rwanda is
unknown and the objective of this study was to determine the nutrition status of a cohort of
patients on dialysis with Stage 5 CKD at select facilities in Kigali and Gisenyi.
Methods: In this cross-sectional study, adults who had been on hemodialysis for more than 30
days were recruited from dialysis centers in Kigali and Gisenyi. Nutrition status was measured
by performing a physical exam and interview known as the Subjective Global Assessment (SGA),
calculating body mass index (BMI), and collecting laboratory values for potassium, phosphorus,
calcium and albumin. SGA scores categorized participants into A (nourished), B (moderately
malnourished) or C (severely malnourished). BMI was categorized as underweight (<22 kg/m2),
normal/overweight (22-29.9 kg/m2), and obese (>30. kg/m2). Laboratory values were
categorized as high, normal or low.
Results: 34 patients were assessed 19 (59.4%) of whom were males and 13 (40.6%) were
females. Mean age for all was 52.4 years. 28% of participants were classified as moderately
malnourished (SGA B) and 62.4% of participants were underweight (BMI <22 kg/m2). There was
a correlation (p =0.0117) between moderate malnutrition and underweight. 69% of participants
presented with high potassium (> 5.10meq/l, mean value 5.49 mEq/L), while the majority of
participants were normal for phosphorus, calcium and albumin. There was no association
between low albumin and moderate malnutrition (p=0.0687) and low albumin and underweight
(p=0.6834).
Conclusion: Malnutrition is prevalent among hemodialysis patients in Rwanda and there may
be an increased risk of morbidity and mortality among patients due to low BMI scores. When
creating nutrition recommendations for hemodialysis patients, potassium restriction should be
emphasized. Additional research could help to draw further conclusions around malnutrition,
laboratory values and dialysis in the region.
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