Skip to main content

Advertisement

Log in

Is malnutrition a determining factor of health-related quality of life in hemodialysis patients? A cross-sectional design examining relationships with a comprehensive assessment of nutritional status

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To identify relationships between health-related quality of life (HRQOL) and nutritional status in hemodialysis (HD) patients.

Method

Secondary data from a cross-sectional survey was utilized. HRQOL was assessed for 379 HD patients using the generic Short Form 36 (SF-36) and disease-specific Kidney-Disease Quality of Life-36 (KDQOL-36). Malnutrition was indicated by malnutrition inflammation score (MIS) ≥ 5, and presence of protein-energy wasting (PEW). The individual nutritional parameters included the domains of physical status, serum biomarkers, and dietary intake. Multivariate associations were assessed using the general linear model.

Results

MIS ≥ 5 was negatively associated with SF-36 scores of physical functioning (MIS < 5 = 73.4 ± 8.0 SE vs MIS ≥ 5 = 64.6 ± 7.7 SE, P < 0.001), role-limitation-physical (MIS < 5 = 65.3 ± 14.3 SE vs MIS ≥ 5 = 52.9 ± 14.0 SE, P = 0.006), general health (MIS < 5 = 53.7 ± 7.5 SE vs MIS ≥ 5 = 47.0 ± 7.1 SE, P = 0.003), and PCS-36 (MIS < 5 = 40.5 ± 3.3 SE vs MIS ≥ 5 = 35.9 ± 3.1 SE, P < 0.001); and KDQOL-36 score of symptoms/problems (MIS < 5 = 78.9 ± 5.6 SE vs MIS ≥ 5 = 74.8 ± 5.4 SE, P = 0.022), but not with PEW by any tool. Of individual nutritional parameters, underweight (68.1 ± 5.4 SE, P = 0.031), normal weight (63.8 ± 2.8 SE, P = 0.023), and overweight (64.3 ± 2.9 SE, P = 0.003) patients had significantly higher physical functioning scores compared to obese patients (44.8 ± 5.5 SE). Serum albumin levels were positively associated with physical functioning (P = 0.041) score. HGS was also positively associated with physical functioning (P = 0.036), and vitality (P = 0.041) scores. Greater dietary phosphorus intakes were significantly associated with lower scores for role limitation-physical (P = 0.008), bodily pain (P = 0.043), and PCS-36 (P = 0.024).

Conclusion

Malnutrition diagnosis by MIS, but not PEW, indicated associations with HRQOL in HD patients. Individual nutritional parameters that related to higher HRQOL were BMI < 30 kg/m2, better dietary phosphorus control, greater muscle strength and higher visceral protein pool.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kalantar-Zadeh, Kopple, Block, & Humphreys. (2001). Association among SF-36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. Journal of the American Society of Nephrology, 12(12), 2797–2806.

    Article  Google Scholar 

  2. Hall, R. K., Luciano, A., Pieper, C., & Colon-Emeric, C. S. (2018). Association of Kidney Disease Quality of Life (KDQOL-36) with mortality and hospitalization in older adults receiving hemodialysis. BMC Nephrology, 19(1), 11. https://doi.org/10.1186/s12882-017-0801-5

    Article  PubMed  PubMed Central  Google Scholar 

  3. Peng, Y.-S., Chiang, C.-K., Hung, K.-Y., Chang, C.-H., Lin, C.-Y., Yang, C.-S., Chen, T.-W., Hsia, C.-C., Chen, D.-L., & Hsu, W.-D. (2010). Are both psychological and physical dimensions in health-related quality of life associated with mortality in hemodialysis patients: A 7-year Taiwan cohort study. Blood Purification, 30(2), 98–105. https://doi.org/10.1159/000319002

    Article  PubMed  Google Scholar 

  4. Perl, J., Karaboyas, A., Morgenstern, H., Sen, A., Rayner, H. C., Vanholder, R. C., Combe, C., Hasegawa, T., Finkelstein, F. O., & Lopes, A. A. (2016). Association between changes in quality of life and mortality in hemodialysis patients: Results from the DOPPS. Nephrology Dialysis Transplantation, 32(3), 521–527. https://doi.org/10.1093/ndt/gfw233

    Article  PubMed Central  Google Scholar 

  5. Ambriz Murillo, Y., Menor Almagro, R., Campos-González, I. D., & Cardiel, M. H. (2015). Health-related quality of life in rheumatoid arthritis, osteoarthritis, diabetes mellitus, end stage renal disease and geriatric subjects. Experience from a general hospital in Mexico. Reumatología Clínica (English Edition), 11(2), 68–72. https://doi.org/10.1016/j.reumae.2014.03.014

    Article  Google Scholar 

  6. James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, Z., Abera, S. F., Abil, O. Z., Abraha, H. N., Abu-Raddad, L. J., Abu-Rmeileh, N. M. E., Accrombessi, M. M. K., et al. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7

    Article  Google Scholar 

  7. Urquhart-Secord, R., Craig, J. C., Hemmelgarn, B., Tam-Tham, H., Manns, B., Howell, M., Polkinghorne, K. R., Kerr, P. G., Harris, D. C., Thompson, S., Schick-Makaroff, K., Wheeler, D. C., van Biesen, W., Winkelmayer, W. C., Johnson, D. W., Howard, K., Evangelidis, N., & Tong, A. (2016). Patient and caregiver priorities for outcomes in hemodialysis: An International Nominal Group Technique Study. American Journal of Kidney Diseases, 68(3), 444–454. https://doi.org/10.1053/j.ajkd.2016.02.037

    Article  PubMed  Google Scholar 

  8. Cukor, D., Cohen, S. D., Peterson, R. A., & Kimmel, P. L. (2007). Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. Journal of the American Society of Nephrology, 18(12), 3042–3055. https://doi.org/10.1681/asn.2007030345

    Article  PubMed  Google Scholar 

  9. Jacobson, J., Ju, A., Baumgart, A., Unruh, M., O’Donoghue, D., Obrador, G., Craig, J. C., Dapueto, J. M., Dew, M. A., & Germain, M. (2019). Patient perspectives on the meaning and impact of fatigue in hemodialysis: A systematic review and thematic analysis of qualitative studies. American Journal of Kidney Diseases. https://doi.org/10.1053/j.ajkd.2019.01.034

    Article  PubMed  Google Scholar 

  10. Cleary, J., & Drennan, J. (2005). Quality of life of patients on haemodialysis for end-stage renal disease. Journal of Advanced Nursing, 51(6), 577–586. https://doi.org/10.1111/j.1365-2648.2005.03547.x

    Article  PubMed  Google Scholar 

  11. Dwyer, J. T., Larive, B., Leung, J., Rocco, M., Burrowes, J. D., Chumlea, W. C., Frydrych, A., Kusek, J. W., & Uhlin, L. (2002). Nutritional status affects quality of life in Hemodialysis (HEMO) Study patients at baseline. Journal of Renal Nutrition, 12(4), 213–223. https://doi.org/10.1053/jren.2002.35297

    Article  PubMed  Google Scholar 

  12. Mazairac, A. H. A., de Wit, G. A., Penne, E. L., van der Weerd, N. C., Grooteman, M. P. C., van den Dorpel, M. A., Nubé, M. J., Buskens, E., Lévesque, R., ter Wee, P. M., Bots, M. L., & Blankestijn, P. J. (2011). Protein-energy nutritional status and kidney disease-specific quality of life in hemodialysis patients. Journal of Renal Nutrition, 21(5), 376-386.e1. https://doi.org/10.1053/j.jrn.2010.08.004

    Article  PubMed  Google Scholar 

  13. Md Yusop, N. B., Yoke Mun, C., Shariff, Z. M., & Beng Huat, C. (2013). Factors associated with quality of life among hemodialysis patients in Malaysia. PLoS ONE, 8(12), e84152. https://doi.org/10.1371/journal.pone.0084152

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Vero, L. M., Byham-Gray, L., Parrott, J. S., & Steiber, A. L. (2013). Use of the subjective global assessment to predict health-related quality of life in chronic kidney disease stage 5 patients on maintenance hemodialysis. Journal of Renal Nutrition, 23(2), 141–147. https://doi.org/10.1053/j.jrn.2012.03.003

    Article  PubMed  Google Scholar 

  15. Donciu, M.-D., Florea, L., Mititiuc, L.-I., Popescu, E.-R., & Chirita, R. (2019). Biochemical and bioimpedance orrelation with quality of life and illness perception in hemodialysis patients. Revista de Chimie, 70(2), 679–684. https://doi.org/10.37358/RC.19.2.6984

    Article  Google Scholar 

  16. Chiang, C. K., Peng, Y. S., Chiang, S. S., Yang, C. S., He, Y. H., Hung, K. Y., Wu, K. D., Wu, M. S., Fang, C. C., Tsai, T. J., & Chen, W. Y. (2004). Health-related quality of life of hemodialysis patients in Taiwan: A multicenter study. Blood Purification, 22(6), 490–498. https://doi.org/10.1159/000081730

    Article  PubMed  Google Scholar 

  17. Germin-Petrović, D., Mesaros-Devcić, I., Lesac, A., Mandić, M., Soldatić, M., Vezmar, D., Petrić, D., Vujicić, B., Basić-Jukić, N., & Racki, S. (2011). Health-related quality of life in the patients on maintenance hemodialysis: The analysis of demographic and clinical factors. Collegium Antropologicum, 35(3), 687–693.

    PubMed  Google Scholar 

  18. Carrero, J. J., Johansen, K. L., Lindholm, B., Stenvinkel, P., Cuppari, L., & Avesani, C. M. (2016). Screening for muscle wasting and dysfunction in patients with chronic kidney disease. Kidney International, 90(1), 53–66. https://doi.org/10.1016/j.kint.2016.02.025

    Article  PubMed  Google Scholar 

  19. Fouque, D., Kalantar-Zadeh, K., Kopple, J., Cano, N., Chauveau, P., Cuppari, L., Franch, H., Guarnieri, G., Ikizler, T. A., Kaysen, G., Lindholm, B., Massy, Z., Mitch, W., Pineda, E., Stenvinkel, P., Trevino-Becerra, A., & Wanner, C. (2008). A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney International, 73(4), 391–398. https://doi.org/10.1038/sj.ki.5002585

    Article  CAS  PubMed  Google Scholar 

  20. Sahathevan, S., Khor, B.-H., Ng, H.-M., Abdul Gafor, A. H., Mat Daud, Z. A., Mafra, D., & Karupaiah, T. (2020). Understanding development of malnutrition in hemodialysis patients: A narrative review. Nutrients, 12(10), 3147. https://doi.org/10.3390/nu12103147

    Article  CAS  PubMed Central  Google Scholar 

  21. Giglio, J., Kamimura, M. A., Lamarca, F., Rodrigues, J., Santin, F., & Avesani, C. M. (2018). Association of sarcopenia with nutritional parameters, quality of life, hospitalization, and mortality rates of elderly patients on hemodialysis. Journal of Renal Nutrition, 28(3), 197–207. https://doi.org/10.1053/j.jrn.2017.12.003

    Article  PubMed  Google Scholar 

  22. Noori, N., Sharma Parpia, A., Lakhani, R., Janes, S., & Goldstein, M. B. (2018). Frailty and the quality of life in hemodialysis patients: The importance of waist circumference. Journal of Renal Nutrition, 28(2), 101–109. https://doi.org/10.1053/j.jrn.2017.07.007

    Article  PubMed  Google Scholar 

  23. Brown, E. A., Zhao, J., McCullough, K., Fuller, D. S., Figueiredo, A. E., Bieber, B., Finkelstein, F. O., Shen, J., Kanjanabuch, T., Kawanishi, H., Pisoni, R. L., & Perl, J. (2021). Burden of kidney disease, health-related quality of life, and employment among patients receiving peritoneal dialysis and in-center hemodialysis: Findings from the DOPPS program. American Journal of Kidney Diseases. https://doi.org/10.1053/j.ajkd.2021.02.327

    Article  PubMed  Google Scholar 

  24. Carrero, J. J., Thomas, F., Nagy, K., Arogundade, F., Avesani, C. M., Chan, M., Chmielewski, M., Cordeiro, A. C., Espinosa-Cuevas, A., Fiaccadori, E., Guebre-Egziabher, F., Hand, R. K., Hung, A. M., Ikizler, T. A., Johansson, L. R., Kalantar-Zadeh, K., Karupaiah, T., Lindholm, B., Marckmann, P., … Kovesdy, C. P. (2018). Global prevalence of protein-energy wasting in kidney disease: A meta-analysis of contemporary observational studies from the International Society of Renal Nutrition and Metabolism. Journal of Renal Nutrition, 28(6), 380–392. https://doi.org/10.1053/j.jrn.2018.08.006

    Article  PubMed  Google Scholar 

  25. Borges, M. C. C., Vogt, B. P., Martin, L. C., & Caramori, J. C. T. (2017). Malnutrition-inflammation score cut-off predicting mortality in maintenance hemodialysis patients. Clinical Nutrition ESPEN, 17, 63–67. https://doi.org/10.1016/j.clnesp.2016.10.006

    Article  PubMed  Google Scholar 

  26. Kalantar-Zadeh, K., Kopple, J. D., Block, G., & Humphreys, M. H. (2001). A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. American Journal of Kidney Diseases, 38(6), 1251–1263. https://doi.org/10.1053/ajkd.2001.29222

    Article  CAS  PubMed  Google Scholar 

  27. Ma, L., & Zhao, S. (2017). Risk factors for mortality in patients undergoing hemodialysis: A systematic review and meta-analysis. International Journal of Cardiology, 238, 151–158. https://doi.org/10.1016/j.ijcard.2017.02.095

    Article  PubMed  Google Scholar 

  28. Carrero, J. J., Stenvinkel, P., Cuppari, L., Ikizler, T. A., Kalantar-Zadeh, K., Kaysen, G., Mitch, W. E., Price, S. R., Wanner, C., Wang, A. Y., ter Wee, P., & Franch, H. A. (2013). Etiology of the protein-energy wasting syndrome in chronic kidney disease: A consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). Journal of Renal Nutrition, 23(2), 77–90. https://doi.org/10.1053/j.jrn.2013.01.001

    Article  PubMed  Google Scholar 

  29. Opiyo, R. O., Nyasulu, P. S., Olenja, J., Zunza, M., Nguyen, K. A., Bukania, Z., Nabakwe, E., Mbogo, A., & Were, A. O. (2019). Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: A mixed-methods survey. Renal Replacement Therapy, 5(1), 41. https://doi.org/10.1186/s41100-019-0237-4

    Article  Google Scholar 

  30. Kawate, Y., & Miyata, H. (2017). The importance of nutritional intervention by dietitians for hyperphosphatemia in maintained hemodialysis patients. Renal Replacement Therapy, 3(1), 19. https://doi.org/10.1186/s41100-017-0095-x

    Article  Google Scholar 

  31. Clark-Cutaia, M. N., Sevick, M. A., Thurheimer-Cacciotti, J., Hoffman, L. A., Snetselaar, L., Burke, L. E., & Zickmund, S. L. (2019). Perceived barriers to adherence to hemodialysis dietary recommendations. Clinical Nursing Research, 28(8), 1009–1029. https://doi.org/10.1177/1054773818773364

    Article  PubMed  Google Scholar 

  32. Zimmerer, J. L., Leon, J. B., Covinsky, K. E., Desai, U., & Sehgal, A. R. (2003). Diet monotony as a correlate of poor nutritional intake among hemodialysis patients. Journal of Renal Nutrition, 13(2), 72–77. https://doi.org/10.1053/jren.2003.50025

    Article  PubMed  Google Scholar 

  33. Sualeheen, A., Khor, B. H., Balasubramanian, G. V., Sahathevan, S., Ali, M. S. M., Narayanan, S. S., Chinna, K., Daud, Z. A. M., Khosla, P., Gafor, A. H. A., & Karupaiah, T. (2020). Habitual dietary patterns of patients on hemodialysis indicate nutritional risk. Journal of Renal Nutrition, 30(4), 322–332. https://doi.org/10.1053/j.jrn.2019.09.010

    Article  CAS  PubMed  Google Scholar 

  34. Zabel, R., Ash, S., King, N., Juffs, P., & Bauer, J. (2012). Relationships between appetite and quality of life in hemodialysis patients. Appetite, 59(1), 194–199. https://doi.org/10.1016/j.appet.2012.02.016

    Article  PubMed  Google Scholar 

  35. Feroze, U., Noori, N., Kovesdy, C. P., Molnar, M. Z., Martin, D. J., Reina-Patton, A., Benner, D., Bross, R., Norris, K. C., Kopple, J. D., & Kalantar-Zadeh, K. (2011). Quality-of-life and mortality in hemodialysis patients: Roles of race and nutritional status. Clinical Journal of the American Society of Nephrology, 6(5), 1100–1111. https://doi.org/10.2215/cjn.07690910

    Article  PubMed  PubMed Central  Google Scholar 

  36. Al-Ali, F., Bieber, B., Pisoni, R., Ezzat, H., AlGhonaim, M., AlHejaili, F., AlGhareeb, S., Saleh, A., Al Maimani, Y., Alyousef, A., Ahmed, H., Hamad, A., & GCC-DOPPS 5 Study Group. (2016). Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012–2015). Saudi Journal of Kidney Diseases and Transplantation, 27(7), 31–41. https://doi.org/10.4103/1319-2442.194888

    Article  Google Scholar 

  37. Broers, N. J., Usvyat, L. A., Kooman, J. P., van der Sande, F. M., Lacson, E., Jr., Kotanko, P., & Maddux, F. W. (2015). Quality of life in dialysis patients: A retrospective cohort study. Nephron, 130(2), 105–112. https://doi.org/10.1159/000430814

    Article  CAS  PubMed  Google Scholar 

  38. Allen, K. L., Miskulin, D., Yan, G., Dwyer, J. T., Frydrych, A., Leung, J., & Poole, D. (2002). Association of nutritional markers with physical and mental health status in prevalent hemodialysis patients from the HEMO study. Journal of Renal Nutrition, 12(3), 160–169. https://doi.org/10.1053/jren.2002.33512

    Article  PubMed  Google Scholar 

  39. Moreira, A. C., Carolino, E., Domingos, F., Gaspar, A., Ponce, P., & Camilo, M. E. (2013). Nutritional status influences generic and disease-specific quality of life measures in haemodialysis patients. Nutricion Hospitalaria, 28(3), 951–957. https://doi.org/10.3305/nh.2013.28.3.6454

    Article  PubMed  Google Scholar 

  40. dos Santos, A. C. B., do Carmo Machado, M., Pereira, L. R., Abreu, J. L. P., & Lyra, M. B. (2013). Association between the level of quality of life and nutritional status in patients undergoing chronic renal hemodialysis. Brazilian Journal of Nephrology, 35(4), 279–288. https://doi.org/10.5935/0101-2800.20130047

    Article  Google Scholar 

  41. Veerappan, I., Arvind, R. M., & Ilayabharthi, V. (2012). Predictors of quality of life of hemodialysis patients in India. Indian Journal of Nephrology, 22(1), 18–25. https://doi.org/10.4103/0971-4065.91185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Sohrabi, Z., Eftekhari, M. H., Eskandari, M. H., Rezaeianzadeh, A., & Sagheb, M. M. (2015). Malnutrition-inflammation score and quality of life in hemodialysis patients: Is there any correlation? Nephro-Urology Monthly, 7(3), e27445–e27445. https://doi.org/10.5812/numonthly.7(3)2015.27445

    Article  PubMed  PubMed Central  Google Scholar 

  43. de Roij van Zuijdewijn, C., Grooteman, M., Bots, M., Blankestijn, P., van den Dorpel, M., Nubé, M., & ter Wee, P. (2016). Comparing tests assessing protein-energy wasting: Relation with quality of life. Journal of Renal Nutrition, 26(2), 111–117. https://doi.org/10.1053/j.jrn.2015.09.003

    Article  Google Scholar 

  44. Han, H., Burrowes, J. D., Houser, R., Chung, M.-C., & Dwyer, J. T. (2012). What is the impact of nutritional status on health-related quality of life in hemodialysis patients? Journal of Renal Nutrition, 22(2), 237–243. https://doi.org/10.1053/j.jrn.2011.05.003

    Article  PubMed  Google Scholar 

  45. Bilgic, A., Akgul, A., Sezer, S., Arat, Z., Ozdemir, F. N., & Haberal, M. (2007). Nutritional status and depression, sleep disorder, and quality of life in hemodialysis patients. Journal of Renal Nutrition, 17(6), 381–388. https://doi.org/10.1053/j.jrn.2007.08.008

    Article  PubMed  Google Scholar 

  46. Rambod, M., Bross, R., Zitterkoph, J., Benner, D., Pithia, J., Colman, S., Kovesdy, C. P., Kopple, J. D., & Kalantar-Zadeh, K. (2009). Association of malnutrition-inflammation score with quality of life and mortality in hemodialysis patients: A 5-year prospective cohort study. American Journal of Kidney Diseases, 53(2), 298–309. https://doi.org/10.1053/j.ajkd.2008.09.018

    Article  PubMed  Google Scholar 

  47. Fouque, D., Vennegoor, M., Ter Wee, P., Wanner, C., Basci, A., Canaud, B., Haage, P., Konner, K., Kooman, J., & Martin-Malo, A. (2007). EBPG guideline on nutrition. Nephrology Dialysis Transplantation, 22(suppl_2), ii45–ii87. https://doi.org/10.1093/ndt/gfm020

    Article  Google Scholar 

  48. K/DOQI. (2020). Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guideline for nutrition in chronic kidney disease: 2020 update. https://doi.org/10.1053/j.ajkd.2020.05.006

  49. Memmer, D. (2013). Implementation and practical application of the nutrition care process in the dialysis unit. Journal of Renal Nutrition, 23(1), 65–73. https://doi.org/10.1053/j.jrn.2012.01.025

    Article  PubMed  Google Scholar 

  50. Swan, W. I., Vivanti, A., Hakel-Smith, N. A., Hotson, B., Orrevall, Y., Trostler, N., Beck Howarter, K., & Papoutsakis, C. (2017). Nutrition care process and model update: Toward realizing people-centered care and outcomes management. Journal of the Academy of Nutrition and Dietetics, 117(12), 2003–2014. https://doi.org/10.1016/j.jand.2017.07.015

    Article  PubMed  Google Scholar 

  51. Wight, J., Edwards, L., Brazier, J., Walters, S., Payne, J., & Brown, C. (1998). The SF-36 as an outcome measure of services for end stage renal failure. BMJ Quality & Safety, 7(4), 209–221. https://doi.org/10.1136/qshc.7.4.209

    Article  CAS  Google Scholar 

  52. Hays, R. D., Kallich, J. D., Mapes, D. L., Coons, S. J., & Carter, W. B. (1994). Development of the kidney disease quality of life (KDQOL) instrument. Quality of Life Research, 3(5), 329–338. https://doi.org/10.1007/BF00451725

    Article  CAS  PubMed  Google Scholar 

  53. Aiyegbusi, O. L., Kyte, D., Cockwell, P., Marshall, T., Gheorghe, A., Keeley, T., Slade, A., & Calvert, M. (2017). Measurement properties of patient-reported outcome measures (PROMs) used in adult patients with chronic kidney disease: A systematic review. PLoS ONE, 12(6), e0179733. https://doi.org/10.1371/journal.pone.0179733

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Black, A. E. (2000). Critical evaluation of energy intake using the Goldberg cut-off for energy intake: Basal metabolic rate. A practical guide to its calculation, use and limitations. International Journal of Obesity, 24(9), 1119. https://doi.org/10.1038/sj.ijo.0801376

    Article  CAS  PubMed  Google Scholar 

  55. Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and psychological measurement, 30(3), 607–610.

    Article  Google Scholar 

  56. Sararaks, S., Azman, A., Low, L., Rugayah, B., Aziah, A., Hooi, L., Razak, M. A., Norhaya, M., Lim, K., & Azian, A. (2005). Validity and reliability of the SF-36: The Malaysian context. Medical Journal of Malaysia, 60(2), 163.

    CAS  Google Scholar 

  57. Goh, K. K. K., Lai, P. S. M., & Lim, S. K. (2019). Cross cultural adaptation and validation of the Malay Kidney Disease Quality of Life (KDQOL-36). BMC Nephrology, 20(1), 226. https://doi.org/10.1186/s12882-019-1397-8

    Article  PubMed  PubMed Central  Google Scholar 

  58. Joshi, V. D., Mooppil, N., & Lim, J. F. Y. (2010). Validation of the Kidney Disease Quality of Life-Short Form: A cross-sectional study of a dialysis-targeted health measure in Singapore. BMC Nephrology, 11(1), 36. https://doi.org/10.1186/1471-2369-11-36

    Article  PubMed  PubMed Central  Google Scholar 

  59. Ware, J. E. (1993). SF-36 health survey: Manual and interpretation guide. The Health Institute, New England Medical Center.

  60. Ware, J. E., Kosinski, M. A., & Keller, S. D. (1995). SF-36 physical and mental health summary scales: A user’s manual. The Health Institute, New England Medical Center.

  61. Peipert, J. D., Nair, D., Klicko, K., Schatell, D. R., & Hays, R. D. (2019). Kidney Disease Quality of Life 36-Item Short Form Survey (KDQOL-36) normative values for the united states dialysis population and new single summary score. Journal of the American Society of Nephrology, 30(4), 654–663. https://doi.org/10.1681/asn.2018100994

    Article  PubMed  PubMed Central  Google Scholar 

  62. Ware, J., Kosinski, M., & Susan, K. (1995). SF-12: How to score the SF-12 Physical and Mental Health Summary Scales. The Health Institute, New England Medical Center.

  63. Khor, B.-H., Sualeheen, A., Sahathevan, S., Chinna, K., Gafor, A. H. A., Bavanandan, S., Goh, B.-L., Morad, Z., Daud, Z. A. M., Khosla, P., Wang, A.Y.-M., Karupaiah, T., Bee, B. C., Ahmad, G., Lim, S. K., Wahab, M. Z. A., Visvanathan, R., Yahya, R., & Pa, T. C. H. I. (2020). Association of dietary patterns with serum phosphorus in maintenance haemodialysis patients: A cross-sectional study. Scientific Reports, 10(1), 12278. https://doi.org/10.1038/s41598-020-68893-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Kalantar-Zadeh, K., Kopple, J. D., Humphreys, M. H., & Block, G. (2004). Comparing outcome predictability of markers of malnutrition-inflammation complex syndrome in haemodialysis patients. Nephrology, Dialysis, Transplantation, 19(6), 1507–1519. https://doi.org/10.1093/ndt/gfh143

    Article  CAS  PubMed  Google Scholar 

  65. Pisetkul, C., Chanchairujira, K., Chotipanvittayakul, N., Ong-Ajyooth, L., & Chanchairujira, T. (2010). Malnutrition-inflammation score associated with atherosclerosis, inflammation and short-term outcome in hemodialysis patients. Journal of the Medical Association of Thailand, 93(Suppl 1), S147–S156.

    PubMed  Google Scholar 

  66. Frisancho, A. R. (1981). New norms of upper limb fat and muscle areas for assessment of nutritional status. American Journal of Clinical Nutrition, 34(11), 2540–2545. https://doi.org/10.1093/ajcn/34.11.2540

    Article  CAS  Google Scholar 

  67. K/DOQI. (2000). K/DOQI clinical practice guidelines for nutrition in chronic renal failure. American Journal of Kidney Diseases, 37(1), S66–S70.

    Google Scholar 

  68. Tee, E., Ismail, M., Nasir, M., & Khatijah, I. (1997). Nutrient composition of Malaysian foods. Malaysian food composition database programme (p. 310). Institute for Medical Research, Kuala Lumpur

  69. Singapore Health Promotion Board. (2003). Food composition guide Singapore. Singapore Health Promotion Board.

  70. Organization, W. H. (1995). Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organization Technical Report Series, 854, 1–452.

    Google Scholar 

  71. James, G., Witten, D., Hastie, T., & Tibshirani, R. (2013). An introduction to statistical learning (Vol. 112). Springer.

  72. Beto, J. A., Ramirez, W. E., & Bansal, V. K. (2014). Medical nutrition therapy in adults with chronic kidney disease: Integrating evidence and consensus into practice for the generalist registered dietitian nutritionist. Journal of the Academy of Nutrition and Dietetics, 114(7), 1077–1087. https://doi.org/10.1016/j.jand.2013.12.009

    Article  PubMed  Google Scholar 

  73. Mak, R. H., Ikizler, A. T., Kovesdy, C. P., Raj, D. S., Stenvinkel, P., & Kalantar-Zadeh, K. (2011). Wasting in chronic kidney disease. Journal of Cachexia, Sarcopenia and Muscle, 2(1), 9–25. https://doi.org/10.1007/s13539-011-0019-5

    Article  PubMed  PubMed Central  Google Scholar 

  74. Vogt, B. P., & Caramori, J. C. T. (2016). Are nutritional composed scoring systems and protein-energy wasting score associated with mortality in maintenance hemodialysis patients? Journal of Renal Nutrition, 26(3), 183–189. https://doi.org/10.1053/j.jrn.2015.11.003

    Article  Google Scholar 

  75. Toledo, F. R., Antunes, A. A., Vannini, F. C., Silveira, L. V., Martin, L. C., Barretti, P., & Caramori, J. C. (2013). Validity of malnutrition scores for predicting mortality in chronic hemodialysis patients. International Urology and Nephrology, 45(6), 1747–1752. https://doi.org/10.1007/s11255-013-0482-3

    Article  PubMed  Google Scholar 

  76. Gracia-Iguacel, C., González-Parra, E., Mahillo, I., & Ortiz, A. (2019). Criteria for classification of protein–energy wasting in dialysis patients: Impact on prevalence. British Journal of Nutrition, 121(11), 1271–1278. https://doi.org/10.1017/S0007114519000400

    Article  CAS  Google Scholar 

  77. Takahashi, H., Inoue, K., Shimizu, K., Hiraga, K., Takahashi, E., Otaki, K., Yoshikawa, T., Furuta, K., Tokunaga, C., Sakakibara, T., & Ito, Y. (2017). Comparison of nutritional risk scores for predicting mortality in Japanese chronic hemodialysis patients. Journal of Renal Nutrition, 27(3), 201–206. https://doi.org/10.1053/j.jrn.2016.12.005

    Article  PubMed  Google Scholar 

  78. de Roij van Zuijdewijn, C. L. M., ter Wee, P. M., Chapdelaine, I., Bots, M. L., Blankestijn, P. J., van den Dorpel, M. A., Nubé, M. J., & Grooteman, M. P. C. (2015). A comparison of 8 nutrition-related tests to predict mortality in hemodialysis patients. Journal of Renal Nutrition, 25(5), 412–419. https://doi.org/10.1053/j.jrn.2015.02.005

  79. Lopes, M. B., Silva, L. F., Lopes, G. B., Penalva, M. A., Matos, C. M., Robinson, B. M., & Lopes, A. A. (2017). Additional Contribution of the Malnutrition-Inflammation Score to predict mortality and patient-reported outcomes as compared with its components in a cohort of African descent hemodialysis patients. Journal of Renal Nutrition, 27(1), 45–52. https://doi.org/10.1053/j.jrn.2016.08.006

    Article  PubMed  Google Scholar 

  80. Johansen, K. L., Kutner, N. G., Young, B., & Chertow, G. M. (2006). Association of body size with health status in patients beginning dialysis. The American Journal of Clinical Nutrition, 83(3), 543–549.

    Article  CAS  Google Scholar 

  81. Forhan, M., & Gill, S. V. (2013). Obesity, functional mobility and quality of life. Best Practice & Research Clinical Endocrinology & Metabolism, 27(2), 129–137. https://doi.org/10.1016/j.beem.2013.01.003

    Article  Google Scholar 

  82. Tong, A., Manns, B., Wang, A. Y. M., Hemmelgarn, B., Wheeler, D. C., Gill, J., Tugwell, P., Pecoits-Filho, R., Crowe, S., Harris, T., Van Biesen, W., Winkelmayer, W. C., Levin, A., Thompson, A., Perkovic, V., Ju, A., Gutman, T., Bernier-Jean, A., Viecelli, A. K., … ONG Implementation Workshop Investigators. (2018). Implementing core outcomes in kidney disease: Report of the Standardized Outcomes in Nephrology (SONG) implementation workshop. Kidney International, 94(6), 1053–1068. https://doi.org/10.1016/j.kint.2018.08.018

    Article  PubMed  PubMed Central  Google Scholar 

  83. Evangelidis, N., Tong, A., Manns, B., Hemmelgarn, B., Wheeler, D. C., Tugwell, P., Crowe, S., Harris, T., Van Biesen, W., & Winkelmayer, W. C. (2017). Developing a set of core outcomes for trials in hemodialysis: An international Delphi survey. American Journal of Kidney Diseases, 70(4), 464–475. https://doi.org/10.1053/j.ajkd.2016.11.029

    Article  PubMed  Google Scholar 

  84. Chan, W., Chin, S. H., Whittaker, A. C., Jones, D., Kaur, O., Bosch, J. A., & Borrows, R. (2019). The associations of muscle strength, muscle mass, and adiposity with clinical outcomes and quality of life in prevalent kidney transplant recipients. Journal of Renal Nutrition, 29(6), 536–547. https://doi.org/10.1053/j.jrn.2019.06.009

    Article  PubMed  Google Scholar 

  85. Sayer, A. A., Syddall, H. E., Martin, H. J., Dennison, E. M., Roberts, H. C., & Cooper, C. (2006). Is grip strength associated with health-related quality of life? Findings from the Hertfordshire Cohort Study. Age and Ageing, 35(4), 409–415. https://doi.org/10.1093/ageing/afl024

    Article  PubMed  Google Scholar 

  86. Jakobsen, L. H., Rask, I. K., & Kondrup, J. (2010). Validation of handgrip strength and endurance as a measure of physical function and quality of life in healthy subjects and patients. Nutrition, 26(5), 542–550. https://doi.org/10.1016/j.nut.2009.06.015

    Article  PubMed  Google Scholar 

  87. Kang, S. Y., Lim, J., & Park, H. S. (2018). Relationship between low handgrip strength and quality of life in Korean men and women. Quality of Life Research, 27(10), 2571–2580. https://doi.org/10.1007/s11136-018-1920-6

    Article  PubMed  Google Scholar 

  88. Nishikawa, H., Enomoto, H., Yoh, K., Iwata, Y., Sakai, Y., Kishino, K., Ikeda, N., Takashima, T., Aizawa, N., Takata, R., Hasegawa, K., Ishii, N., Yuri, Y., Nishimura, T., Iijima, H., & Nishiguchi, S. (2018). Health-related quality of life in chronic liver diseases: A strong impact of hand grip strength. Journal of Clinical Medicine, 7(12), 553. https://doi.org/10.3390/jcm7120553

    Article  PubMed Central  Google Scholar 

  89. Sayer, A. A., Dennison, E. M., Syddall, H. E., Gilbody, H. J., Phillips, D. I., & Cooper, C. (2005). Type 2 diabetes, muscle strength, and impaired physical function: The tip of the iceberg? Diabetes Care, 28(10), 2541–2542. https://doi.org/10.2337/diacare.28.10.2541

    Article  PubMed  Google Scholar 

  90. McNicholl, T., Curtis, L., Dubin, J. A., Mourtzakis, M., Nasser, R., Laporte, M., & Keller, H. (2020). Handgrip strength predicts length of stay and quality of life in and out of hospital. Clinical Nutrition, 39(8), 2501–2509. https://doi.org/10.1016/j.clnu.2019.11.006

    Article  PubMed  Google Scholar 

  91. Oliveira, M. C., Bufarah, M. N. B., & Balbi, A. L. (2018). Handgrip strength in end stage of renal disease—A narrative review. Nutrire, 43(1), 14. https://doi.org/10.1186/s41110-018-0073-2

    Article  Google Scholar 

  92. Martin-Alemañy, G., de los Ángeles Espinosa-Cuevas, M., Pérez-Navarro, M., Wilund, K. R., Miranda-Alatriste, P., Cortés-Pérez, M., García-Villalobos, G., Gómez-Guerrero, I., Cantú-Quintanilla, G., Ramírez-Mendoza, M., & Valdez-Ortiz, R. (2020). Effect of oral nutritional supplementation with and without exercise on nutritional status and physical function of adult hemodialysis patients: A Parallel Controlled Clinical Trial (AVANTE-HEMO Study). Journal of Renal Nutrition, 30(2), 126–136. https://doi.org/10.1053/j.jrn.2019.06.010

    Article  CAS  Google Scholar 

  93. Lopes, A. A., Bragg-Gresham, J. L., Goodkin, D. A., Fukuhara, S., Mapes, D. L., Young, E. W., Gillespie, B. W., Akizawa, T., Greenwood, R. N., Andreucci, V. E., Akiba, T., Held, P. J., & Port, F. K. (2007). Factors associated with health-related quality of life among hemodialysis patients in the DOPPS. Quality of Life Research, 16(4), 545–557. https://doi.org/10.1007/s11136-006-9143-7

    Article  PubMed  Google Scholar 

  94. Keller, U. (2019). Nutritional laboratory markers in malnutrition. Journal of Clinical Medicine, 8(6), 775. https://doi.org/10.3390/jcm8060775

    Article  CAS  PubMed Central  Google Scholar 

  95. Hanafusa, N., Nitta, K., Okazaki, M., Komatsu, M., Shiohira, S., Kawaguchi, H., & Tsuchiya, K. (2017). Serum albumin level adjusted with C-reactive protein predicts hemodialysis patient survival. Renal Replacement Therapy, 3(1), 9. https://doi.org/10.1186/s41100-016-0085-4

    Article  Google Scholar 

  96. Kalantar-Zadeh, K., Kuwae, N., Wu, D. Y., Shantouf, R. S., Fouque, D., Anker, S. D., Block, G., & Kopple, J. D. (2006). Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients. The American Journal of Clinical Nutrition, 83(2), 202–210. https://doi.org/10.1093/ajcn/83.2.202

    Article  CAS  PubMed  Google Scholar 

  97. Kalender, B., Ozdemir, A. C., Dervisoglu, E., & Ozdemir, O. (2007). Quality of life in chronic kidney disease: Effects of treatment modality, depression, malnutrition and inflammation. International Journal of Clinical Practice, 61(4), 569–576. https://doi.org/10.1111/j.1742-1241.2006.01251.x

    Article  CAS  PubMed  Google Scholar 

  98. Nowak, K. L., & Chonchol, M. (2018). Does inflammation affect outcomes in dialysis patients? Seminars in Dialysis, 31(4), 388–397. https://doi.org/10.1111/sdi.12686

    Article  PubMed  PubMed Central  Google Scholar 

  99. K/DOQI. (2003). K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. American Journal of Kidney Diseases, 42(4 Suppl 3), S1-201.

    Google Scholar 

  100. Lacson, E., Jr., Xu, J., Lin, S. F., Dean, S. G., Lazarus, J. M., & Hakim, R. (2009). Association between achievement of hemodialysis quality-of-care indicators and quality-of-life scores. American Journal of Kidney Diseases, 54(6), 1098–1107. https://doi.org/10.1053/j.ajkd.2009.07.017

    Article  PubMed  Google Scholar 

  101. Ware, J. E., Jr., Gandek, B., Kosinski, M., Aaronson, N. K., Apolone, G., Brazier, J., Bullinger, M., Kaasa, S., Leplège, A., & Prieto, L. (1998). The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: Results from the IQOLA project. Journal of Clinical Epidemiology, 51(11), 1167–1170. https://doi.org/10.1016/s0895-4356(98)00108-5

    Article  PubMed  Google Scholar 

  102. Lam, C. L., Eileen, Y., Gandek, B., & Fong, D. Y. (2005). The SF-36 summary scales were valid, reliable, and equivalent in a Chinese population. Journal of Clinical Epidemiology, 58(8), 815–822. https://doi.org/10.1016/j.jclinepi.2004.12.008

    Article  PubMed  Google Scholar 

  103. Yarlas, A. S., White, M. K., Yang, M., Saris-Baglama, R. N., Bech, P. G., & Christensen, T. (2011). Measuring the health status burden in hemodialysis patients using the SF-36(R) health survey. Quality of Life Research, 20(3), 383–389. https://doi.org/10.1007/s11136-010-9764-8

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Members of PaTCH (Malaysia) Investigators are Dr. Bee Boon Cheak (Hospital Selayang, Malaysia), Dr. Lim Soo Kun (Universiti Malaya, Malaysia), Dr. Ravindran Visvanathan (Hospital Kuala Lumpur, Malaysia), Dr. Rosnawati Yahya (Hospital Kuala Lumpur, Malaysia), and Dr. Sunita Bavanandan (Hospital Kuala Lumpur, Malaysia)

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Tilakavati Karupaiah.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ng, HM., Khor, BH., Sahathevan, S. et al. Is malnutrition a determining factor of health-related quality of life in hemodialysis patients? A cross-sectional design examining relationships with a comprehensive assessment of nutritional status. Qual Life Res 31, 1441–1459 (2022). https://doi.org/10.1007/s11136-021-03018-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-021-03018-6

Keywords

Navigation