Dietary nutrient intake and nutritional status in maintenance hemodialysis patients: a multicenter cross-sectional survey

Figures & data

Figure 1. The research flowchart of the research.

Table 1. Dietary nutrient intake, blood test indexes and nutritional status in maintenance hemodialysis patients.

Projects	Minimum	Maximum	Mean ± SD
DEI, Kcal/d	803.56	3811.60	1755.97 ± 468.43
nDEI, Kcal/kg/d	12.75	61.60	29.06 ± 7.79
DPI, g/d	11.61	132.81	59.74 ± 19.29
nDPI, g/kg/d	0.21	2.04	0.99 ± 0.32
Dietary fiber intake, g/d	2.03	37.34	9.96 ± 5.30
Dietary calcium intake, mg/d	68.07	2293.84	435.56 ± 217.14
Dietary phosphorus intake, mg/d	197.77	1914.48	832.89 ± 250.30
Dietary potassium intake, mg/d	380.15	5614.19	1644.97 ± 666.23
Dietary sodium intake, mg/d	164.29	10008.94	3305.25 ± 1468.16
Serum potassium, mmol/L	3.10	6.80	4.90 ± 0.70
Serum sodium, mmol/L	129.00	146.00	138.17 ± 3.01
Serum creatinine, umol/L	308.00	1665.00	922.59 ± 244.33
Serum urea nitrogen, mmol/L	7.10	49.00	24.32 ± 5.98
Serum phosphorus, mmol/L	0.47	4.50	1.77 ± 0.58
Serum calcium, mmol/L	1.21	3.78	2.18 ± 0.24
BMI, Kg/m^2	14.20	38.70	23.32 ± 3.79
SGA	2.00	7.00	6.25 ± 0.84
Serum albumin, g/L	20.10	50.20	39.64 ± 3.52
HGS (male), kg	7.80	63.80	30.98 ± 9.54
HGS (female), kg	2.40	64.00	19.54 ± 7.47

Abbreviations: SD, standard deviation; DEI, dietary energy intake; nDEI, normalized daily energy intake; DPI, dietary protein intake; nDPI, normalized daily protein intake; BMI, body mass index; SGA, subjective global assessment; HGS, handgrip strength.

Table 2. Correlations among disease control indexes in maintenance hemodialysis patients.

Projects	Kt/V	Serum urea nitrogen	Serum potassium	Serum phosphorus	Serum creatinine
Serum urea nitrogen	− 0.081
Serum potassium	− 0.106	0.320*
Serum phosphorus	− 0.056	0.362**	0.323**
Serum creatinine	− 0.191**	0.370**	0.092	0.336**
Dialysis fluid removal	− 0.080	0.101	− 0.011	0.008	0.165**

Notes: *p < 0.05, **p < 0.01.

Table 3. Influence of gender and comorbidity-diabetes on dietary nutrient intake in maintenance hemodialysis patients.

Projects	Male	Female	t	P	No-diabetes	Diabetes	t	P
nDPI	0.98 ± 0.31	1.00 ± 0.34	−0.809	0.419	1.03 ± 0.33	0.92 ± 0.29	3.223	0.001
DPI	63.87 ± 19.64	53.55 ± 17.04	5.301	<0.001	61.20 ± 19.71	57.42 ± 18.02	1.828	0.068
nDEI	28.58 ± 7.43	29.77 ± 8.26	−1.472	0.142	30.16 ± 7.89	27.28 ± 7.15	3.492	0.001
DEI	1867.13 ± 468.71	1589.59 ± 417.13	5.923	<0.001	1791.55 ± 481.34	1702.18 ± 427.17	1.788	0.075
Dietary potassium intake	1738.80 ± 727.03	1504.54 ± 535.34	3.414	0.001	1700.52 ± 687.16	1566.44 ± 625.56	1.863	0.063
Dietary phosphorus intake	883.31 ± 249.56	757.42 ± 2332.49	4.964	<0.001	855.16 ± 256.15	804.86 ± 240.29	1.857	0.064
Dietary fiber intake	10.38 ± 5.62	9.35 ± 4.74	1.872	0.062	10.44 ± 5.82	9.35 ± 4.29	2.052	0.041
Dietary sodium intake	3375.25 ± 1590.99	3200.48 ± 1260.01	1.141	0.255	3288.25 ± 1418.43	3225.26 ± 1515.94	0.400	0.689
Dietary calcium intake	454.19 ± 230.38	407.67 ± 193.06	2.061	0.040	448.623 ± 208.748	423.395 ± 237.523	1.062	0.289

Abbreviations: nDPI, normalized daily protein intake; DPI, dietary protein intake; nDEI, normalized daily energy intake; DEI, dietary energy intake.

Table 4. Multiple linear regression analysis of factors associated with dietary nutrient intake in maintenance hemodialysis patients.

Model	B	SE B	β	95% CI	P	R^2	Adjusted R^2	F	df	P
DEI						0.147	0.140	20.967	3	<0.001
Gender	−268.125	47.758	−0.284	−362,041, −174.209	<0.001
Age	−7.334	1.752	−0.208	−10.779, −3.888	<0.001
Comorbidity-diabetes	−121.374	48.658	−0.126	−217.061, −25.688	0.013
nDEI						0.032	0.030	12.194	1	0.001
Comorbidity-diabetes	−2.880	0.825	−0.180	−4.501, −1.258	0.001
DPI						0.112	0.104	15.268	3	<0.001
Gender	−9.979	2.015	−0.255	−13.942, −6.016	<0.001
Age	−0.240	0.074	−0.165	−0.386, −0.095	0.001
Comorbidity-diabetes	−5.106	2.053	−0.129	−9.143, −1.068	0.013
nDPI						0.028	0.025	10.387	1	0.001
Comorbidity-diabetes	−0.109	0.034	−0.166	−0.176, −0.043	0.001

Depiction: Gender: 1 = male, 2 = female; Comorbidity-diabetes: 0= no, 1= yes.

Abbreviations: nDPI, normalized daily protein intake; DPI, dietary protein intake; nDEI, normalized daily energy intake; DEI, dietary energy intake.

Table 5. Correlation between dietary nutrient intake and blood test indexes and nutritional status in maintenance hemodialysis patients.

	Blood test indexes					Nutritional indicators
Projects	Kt/V	Serum urea nitrogen	Serum creatinine	Serum phosphorus	Serum potassium	SGA	HGS (male)	HGS (female)
nDPI	0.101	0.101*	0.085	0.070	−0.030	0.125*	0.215**	0.049
DPI	−0.109*	0.080	0.200**	0.045	−0.083	0.135*	0.341**	0.032
nDEI	0.025	0.061	0.098	0.082	0.008	0.116*	0.142*	0.158
DEI	−0.226*	0.043	0.241**	0.064	−0.051	0.125*	0.241**	0.128
Dietary potassium intake	−0.140*	−0.011	0.129*	0.072	0.046	0.148**	0.166*	0.121
Dietary phosphorus intake	−0.195**	0.061	0.199**	0.117*	−0.012	0.156**	0.258**	0.139
Dietary fiber intake	−0.095	0.002	0.157**	0.142**	0.039	0.086	0.252**	0.190*
Dietary sodium intake	−0.051	−0.144**	0.031	0.029	−0.042	−0.024	0.057	0.020

Notes: *p < 0.05, **p < 0.01.

Abbreviations: nDPI, normalized daily protein intake; DPI, dietary protein intake; nDEI, normalized daily energy intake; DEI, dietary energy intake; SGA, subjective global assessment; HGS, handgrip strength.

Table 6. Differences in nutritional status of maintenance hemodialysis patients in different nDEI and nDPI groups.

Projects	n (%)	Serum albumin			SGA				HGS(male)				HGS(female)
		Mean ± SD	F	P	Mean ± SD	F	P	n (%)	Mean ± SD	F	P	n (%)	Mean ± SD	F	P
nDEI			0.826	0.439		3.913	0.021			6.446	0.002			0.133	0.875
<25 (low)	116 (30.4%)	39.68 ± 3.30			6.07 ± 0.99			72 (31.4%)	27.80 ± 9.04			44 (28.8%)	19.41 ± 8 .87
25 ∼ 30 (slightly low)	117 (30.6%)	39.32 ± 3.85			6.32 ± 0.70			77 (33.7%)	31.84 ± 9.61			40 (26.1%)	20.16 ± 8.46
>30 (normal)	149 (39.0%)	39.87 ± 3.42			6.36 ± 0.76			80 (34.9%)	33.02 ± 9.29			69 (45.1%)	20.51 ± 13.34
nDPI			1.233	0.293		3.106	0.046			2.258	0.107			0.069	0.933
<0.8 (low)	102 (26.7%)	39.91 ± 3.53			6.06 ± 1.06			60 (26.2%)	30.22 ± 9.17			42 (27.4%)	19.58 ± 9.35
0.8 ∼ 1.0 (slightly low)	123 (32.2%)	39.24 ± 3.45			6.31 ± 0.67			77 (33.6%)	29.66 ± 10.16			46 (30.1%)	20.18 ± 8.13
>1.0 (normal)	157 (41.1%)	39.78 ± 3.57			6.33 ± 0.76			92 (40.2%)	32.58 ± 9.54			65 (42.5%)	20.39 ± 13.55

Abbreviations: SD, standard deviation; nDEI, normalized daily energy intake; nDPI, normalized daily protein intake; SGA, subjective global assessment; HGS, handgrip strength.S.

Table

Date	Meals	Staple food	Non-staple food		Fruits	Other foods	Water, soup, drinks	Salt	Oil	Other spices
			Vegetables	Milk, egg, Tofu, poultry, fish, meat. etc.
The first day	Breakfast
	Lunch
	Dinner
	Extra meal
The second day	Breakfast
	Lunch
	Dinner
	Extra meal
The third day	Breakfast
	Lunch
	Dinner
	Extra meal

Note: 1. Please record in detail the name and weight of the food eaten at each meal for three consecutive days, and the total amount of salt, water (soup) and oil for one day.

2. Solid food recording unit: (g), liquid food recording unit: (mL).

Figure 2.1. Handwritten Chinese version of a 3-day food record form.

Figure 2.2. English version of the 3-day food record form.

Data availability statement

Data are available from the corresponding author upon reasonable request.