The comparison of dietary intake and appetite between normal weight and obese patients under hemodialysis

Impaired appetite and food intake are among the risk factors of malnutrition in advanced kidney failure. On the other hand, the effect of obesity is affirmative in dialysis in contrast to normal population. This study aimed to compare the appetite and food intake in obese and normal weight patients undergoing hemodialysis. In this case-control study 48 obese patients (BMI&ge30kg/m2) and 52 normal weight patients (18.52) under hemodialysis were studied using 24-hour dietary recall (two dialysis and two non-dialysis days) and ADAT questionnaire (The Appetite and Diet Assessment Tool). The statistical analysis were performed by Nutritionist 4 and SPSS 22.0. Appetite status was significantly better in obese group (P=0.03). Energy intake was 32.5±12.8 kcal/kg and protein intake was 1.33±0.51 gr/kg in whole the study population, which was not significantly different between groups. No significant difference was observed between groups in terms of energy and protein efficacy compared to the recommendations. However, energy intake in 59% of normal weight and 53.5 % of obese group, and protein intake in 43.6 % of normal weight and 48.8 % of obese group was less than the recommended values. Micronutrients intake showed no significant differences between groups. Potassium and phosphorus intake was higher than the recommendations in 24.4% and 32.9% of patients respectively. Despite the better appetite status in obese patients, the mean intake of energy and protein was not statistically different between groups. Although a considerable percentage of patients had less intake compared to the recommended energy and protein values in both groups. Thus, it seems that higher BMI is not a reliable indicator of appropriate nutritional intake in hemodialysis.