Sex-based variations in the nutritional and functional status of hemodialysis patients in Palestine: a cross-sectional study.

Abstract

Introduction: Hemodialysis affects patients' nutritional status in several ways, resulting in malnutrition, which, in turn, increases the rates of morbidity and mortality worldwide. The main aim of this study was to comprehensively examine the effect of sex-based differences on the nutritional status of Palestinian patients on hemodialysis.

Methodology: This study involved hemodialysis patients from An-Najah National University Hospital (NNUH) at Nablus/Palestine. A structured questionnaire was used in this study to collect data about sociodemographic data, medical history, lifestyle habits, and functional status, as well as nutritional status, which was assessed using 4 components (anthropometric measurements, biochemical data, clinical data, and dietary data). Patients' reports were reviewed to obtain laboratory values. The malnutrition-inflammation score was used to assess the prevalence of malnutrition. Data were analyzed using univariate and multivariate analysis.

Results: A total of 188 hemodialysis patients participated in the study. The mean age was 57.8 ± 14.0 years, ranging from 19 to 86 years old. Females were more likely to experience nausea and headache during hemodialysis than men (p < 0.05). The findings also showed that the MIS score was significantly higher in women than in men. Biochemical findings revealed that female patients had significantly lower levels of blood urea nitrogen (p = 0.003), carbon dioxide (p = 0.020), ferritin levels (p = 0.025), and serum phosphate levels (p = 0.000). In addition, women had significantly lower intakes of total carbohydrate, total fat, saturated fat, monounsaturated fatty acids, water, vitamin B1, vitamin B2, vitamin B3, calcium, phosphate, sodium, and zinc, except for vitamin B12, which was higher in females. Furthermore, functional assessments indicated that males have significantly higher handgrip strength than females, while females represented more severe malnutrition compared to males.

Conclusion: Our data indicates that women have more severe malnutrition compared to men, suggesting the need to consider sex-based nutritional and functional differences in hemodialysis patients by healthcare professionals.