Prevalence of malnutrition and associated factors among patients undergoing Hemodialysis at Mnazi mmoja hospital – Zanzibar, Tanzania

Abstract

ABSTRACT Background: Malnutrition is common among patients undergoing maintenance hemodialysis. It is associated with increased hospitalization, cardiovascular complications, and reduced quality of life. Therefore, it is important to diagnose malnutrition earlier to enhance timely and adequate nutritional support, and intervention, and help maintain the health and wellness of the patient. The study was conducted to evaluate the nutritional status and associated factors among patients undergoing hemodialysis at Mnazi Mmoja Hospital in Zanzibar. Methodology: This was a cross-sectional study employing a quantitative approach to examine the nutritional status of 136 Chronic Kidney Disease (CKD) dialysis patients. The participants were recruited using a convenient sampling method, and data were collected using a researcher-administered semi-structured questionnaire. To assess nutritional status, BMI-WHO categories and the Subjective Global Assessment (SGA) tool were employed. The data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 26. Clinical characteristics and nutritional status were presented using statistical tables and figures. Factors associated with nutritional status were assessed using a Chi-square test with a P-value set at 0.05 Result: A total of 136 hemodialysis patients in the study. The mean age of all participants was 45 ± 12 years. Most of the participants were males n=69 (50.7%), married n=94 (69.1%), about n=67 (49.3%) had secondary education, and n=84 (61.8%) resided in the urban area. Nearly half n=59 (43.4%) of participants were diagnosed with CKD in less than a year whereby, n=68, (50%) of participants had been on hemodialysis for less than 12 months, and the majority n=131 (96.3%) were doing hemodialysis twice a week. According to WHO- BMI categories, 28(20.6%) [95%CI (47-63.9)] of the participants were underweight, 34(25%)[95%CI(34-56)] were overweight and14(10.3% )[95%CI(11-29)]were obese. Using SGA, malnutrition was present that overall malnutrition was n=82(60.3%) [95%CI (58.9-68.1)], where n=67 (81.7%) [95% CI (71.9- 88.6)] had moderate malnutrition and n=15 (18.3 %) [95/% CI (11.4-28.0)]-had severe malnutrition. On univariate logistic regression analysis, dialysis access, duration of dialysis, and duration of CKD were associated with malnutrition. Conclusion and recommendation: Malnutrition was prevalent in over two-thirds of the participants included in the study. Based on these findings, it is recommended to conduct regular nutritional screenings for malnutrition among hemodialysis patients and provide timely dietary education and support to enhance their nutritional status. Additionally, a comprehensive study should be conducted to assess patients’ adherence to nutritional guidelines and identify challenges faced by healthcare providers in meeting the nutritional needs of their clients.