Submitted to: Journal of Renal Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/1/2005
Publication Date: 2/15/2006
Citation: Wilson, G., Molaison, E.F., Pope, J., Hunt, A.E., Connell, C.L. 2006. Nutritional status and food insecurity in hemodialysis patients. Journal of Renal Nutrition. 16(1):54-58. Interpretive Summary: Hemodialysis (HD) is a treatment for chronic kidney failure that may lead to poor nutritional status. This study examined if a relationship exists between nutritional status and food insecurity of patients whose chronic kidney failure is being treated by hemodialysis. Ninety-eight patients at three HD clinics in northeastern Louisiana were examined for nutritional status by a Subjective Global Assessment (SGA) process and for food insecurity using a USDA developed instrument called U.S. Household Food Security Survey Module (USFSSM). Patients characteristics were: average age of 59 years, 49% were male and 53% female, and 44% were African Americans and 56% were Caucasians. African Americans patients were significantly more food insecure. The percentage of food insecure patients was 16% as compared to a national average of 11.7% and a Louisiana average of 12.9%. Patients with higher educational levels were more likely to have better nutritional status. Overall, 64% of patients were mildly-moderately malnourished and another 13% were severely malnourished. Patients receiving hemodialysis treatment need to be checked for possible food insecurity in order for appropriate intervention to be planned and carried out by renal health care professionals.
Technical Abstract: Objective: The purpose of this study was to determine if a relationship exists between nutrition status, and food security of patients on hemodialysis (HD). Design: A descriptive, correlation study. Setting: This study consisted of HD patients undergoing treatment at three northeast Louisiana dialysis centers. Subjects: Ninety-eight HD patients participated in the study. Mean age of the subjects was 59.1 ± 14.2 years. The sample was 44% Caucasian and 56% African American; 49% male and 51% female. Results: Multiple linear regression and Chi square analysis were used to assess relationships between demographics and food insecurity scores and SGA scores. Race significantly predicted food insecurity (' = 0.248; p = 0.019) with African Americans being more food insecure than Caucasians. A significant positive relationship was found between the level of education and SGA scores (' = 0.222; p = 0.037). In this sample, 16.3% of the subjects were found to be food insecure, and 64.3% of the patients were mildly-moderately malnourished, while another 13.3% were severely malnourished. Conclusions: Future research in this area should include food security questions related to the ability to obtain foods for health. Renal healthcare professionals should assess patients for possible food insecurity so that appropriate interventions can be implemented.