Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index

Sualeheen A 1 , Khor BH 2 , Balasubramanian GV 3 , Sahathevan S 3 , Chinna K 4 , Mat Daud ZA 5 Show all authors , Khosla P 6 , Abdul Gafor AH 7 , Karupaiah T 8 , PaTCH (Malaysia) Investigators

Affiliations 

  • 1 Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia; School of Exercise and Nutritional Science, Faculty of Health, Deakin University, Burwood, Victoria, Australia
  • 2 Faculty of Food Science and Nutrition, University Malaysia Sabah, Kota Kinabalu, Malaysia
  • 3 Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 4 Faculty of Business and Management, USCI University, Cheras, Kuala Lumpur, Malaysia
  • 5 Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • 6 Department of Nutrition and Food Science, Wayne State University, Detroit, MI
  • 7 Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
  • 8 School of Biosciences, Faculty of Health & Medical Science, Taylor's University Lakeside Campus, Jalan Taylor's, Subang Jaya, Selangor, Malaysia. Electronic address: tilly_karu@yahoo.co.uk
J Ren Nutr, 2022 Nov;32(6):726-738.
PMID: 35182714 DOI: 10.1053/j.jrn.2022.02.002

Abstract

OBJECTIVES: This study modified Healthy Eating Index (HEI) based on hemodialysis (HD)-specific nutritional guidelines and investigated associations between the diet quality (DQ) and nutritional risk in HD patients.

METHODS: The HD-HEI tool adapted the Malaysian Dietary Guidelines 2010 framework according to HD-specific nutrition guidelines. This HD-HEI was applied to 3-day dietary records of 382 HD patients. Relationships between HD-HEI scores and nutritional parameters were tested by partial correlations. Binary logistic regression models adjusted with confounders were used to determine adjusted odds ratio (adjOR) with 95% confidence interval (CI) for nutritional risk based on HD-HEI scores categorization.

RESULTS: The total HD-HEI score (51.3 ± 10.2) for this HD patient population was affected by ethnicity (Ptrend < .001) and sex (P = .003). No patient achieved "good" DQ (score: 81-100), while DQ of 54.5% patients were classified as "needs improvement" (score: 51-80) and remaining as "poor" (score: 0-51). Total HD-HEI scores were positively associated with dietary energy intake (DEI), dietary protein intake (DPI), dry weight, and handgrip strength, but inversely associated with Dietary Monotony Index (DMI) (all P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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