Association Between Sociodemographic, Clinical Factors, Nutritional Status, Dietary Factors and Bone Quality with Serum Phosphate Level Among Hemodialysis Patients

Ng, Pee Chien (2020) Association Between Sociodemographic, Clinical Factors, Nutritional Status, Dietary Factors and Bone Quality with Serum Phosphate Level Among Hemodialysis Patients. [Project Paper] (Submitted)

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Abstract

Hyperphosphatemia is the main cause of morbidity and mortality in chronic kidney disease patients. This study aimed to determine the associations between sociodemographic factors, clinical factors, nutritional status, dietary factors and bone quality with serum phosphate level among hemodialysis (HD) patients. This was a cross-sectional study involved 99 hemodialysis patients. Interviewer-administrated questionnaire was used to obtain information on sociodemographic and clinical factors. Body mass index (BMI), serum albumin and serum phosphate were retrieved from medical records as secondary data. Besides, two-day dietary data was obtained on non-dialysis day (using diet recall) and dialysis day (using food record). Bone quality of patients was determined using Quantitative ultrasound measurement on the radial part of non-dialysis arm. Statistical Package for Social Sciences (SPSS) version 24 was used in data analysis, with significant level set at p < 0.05. The mean age and dialysis duration of patients were 56.0 + 11.0 years old and 65.29 + 53.75 months, respectively. The prevalence of hyperphosphatemia was high with approximately 80% of the patients had high serum phosphate level. About half of the patients were either overweight or obese. Dietary protein intake was unsatisfactory with 87.9% had inadequate intake. Despite a majority of the patients (74.7%) claimed themselves complied with phosphate binder prescription, this results should be interpreted cautiously in view of the high prevalence of hyperphosphatemia and excessive dietary phosphorus intake among the patients. There was approximately half of the patients with low bone quality while mean dietary acid load (DAL) was higher than previous studies. On the other hand, serum phosphate level was correlated negatively with age (r=-0.365, p<0.001) but associated positively with educational level (χ2= 15.725, p<0.001) and compliance to phosphate binder (r= 5.929, p= 0.021). Conclusion: Hyperphosphatemia was prevalent among HD patients which deserve attentions from relevant authorities. Poorer serum phosphate level among younger patients and educated patients is not uncommon, which signify the attention of healthcare professional including dietitians to be sensitive with the serum phosphate compliance of young and or educated patients. Despite there were no significant associations found between serum phosphate levels and dietary acid load and bone quality, the high prevalence of poor bone quality and high DAL among the HD patients deserve more studies in the future on these relatively under-studied aspects.

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Mr Khoirul Asrimi Md Nor
Date Deposited:	21 Aug 2023 07:47
Last Modified:	21 Aug 2023 07:47
URI:	http://psaspb.upm.edu.my/id/eprint/873

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