Nutritional Adequacy and Patient Perceptions of the Hospital Inpatient Haemodialysis Menu: A Mixed Methods Case Series

Abstract

Aim: To evaluate the nutritional adequacy of the hospital haemodialysis menu, quantify the dietary intake of hospitalised haemodialysis patients and explore patient perceptions of the menu. Methods: The menu analysis compared the default menu to reference standards using a one sample t-test via SPSS. Eight hospitalised haemodialysis patients were purposively interviewed using semi-structured interviews. Thematic analysis was used to identify the dominant themes. The participant’s actual dietary intake was calculated and compared to individual nutrients using evidence-based guidelines. Results: Compared to the reference standards, the default inpatient haemodialysis menu did not provide adequate energy (p < 0.001, mean = 8767 kJ/day ± 362), sodium (p < 0.001, mean = 72 mmol/day ± 9), potassium (p < 0.001, mean = 64 mmol/day ± 4), vitamin C (p ≤ 0.001, mean = 33 mg/day ± 10) and fibre (p < 0.001, mean = 26 g/day ± 3). Inadequate intake of energy and protein occurred in half of the participants. Passive acceptance of the menu, environmental and cultural considerations contributed to missed food opportunities impacting the patient experience and limited intake. Conclusions: The profile of the current default inpatient haemodialysis menu impacts the dietary intake and the experience of haemodialysis inpatients. It is recommended that the default menu is optimised in line with evidence-based guidelines for inpatients.