Investigating the relationship between the level of serum albumin and body mass index, as nutritional indicators, with dialysis adequacy in patients under hemodialysis

Mohammad Abedi-Samakoosh, Fatemeh Ahangarkani, Kosar Yaghubi, Bahram Adelani

DOI: 10.22122/cdj.v6i1.250


BACKGROUND: Patients with end-stage renal disease (ESRD) who undergo hemodialysis have many complications; one of the most important of which is malnutrition, which affects these patients’ quality of life. The aim of this study was to evaluate serum albumin and body mass index (BMI) as nutritional indicators, and their relationship with dialysis adequacy in patients under hemodialysis.

METHODS: In this study, 100 patients who underwent hemodialysis in Razi Hospital, Qaemshahr City, Iran, in 2016 were selected via convenience sampling method. The data were collected using demographic questionnaire, albumin test, and measuring height and weight of patients. Data were analyzed using linear regression and correlation coefficient tests.

RESULTS: The correlation between the hemodialysis adequacy with albumin was 0.634, which was significant
(P < 0.050). For the second hypothesis, the quality of dialysis with BMI was not positively correlated. The correlation between the hemodialysis adequacy with BMI was -0.007, which was not significant (P > 0.050). Although, in the third hypothesis, the regression between the adequacy of hemodialysis, as a dependent variable, and serum albumin and BMI, as independent variables, indicated significant relationship between serum albumin and hemodialysis adequacy; but there was no significant relationship between BMI and adequacy of hemodialysis.

CONCLUSION: Adequacy of hemodialysis is in relationship with malnutrition and improving the KT/V dialysis adequacy may have a significant effect on the malnutrition control in these patients.


Hemodialysis; Serum Albumin; Body Mass Index

Full Text:



Oliveira GT, Andrade EI, Acurcio FA, Cherchiglia ML, Correia MI. Nutritional assessment of patients undergoing hemodialysis at dialysis centers in Belo Horizonte, MG, Brazil. Rev Assoc Med Bras (1992) 2012; 58(2): 240-7.

Shahbazian H, Rezaii I. Diabetic kidney disease; Review of the current knowledge. J Renal Inj Prev 2013; 2(2): 73-80.

O'Connell Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Surgical nursing kidney and urinary tract diseases. Trans. Masrour-Roudsari D, Hazraty M. Tehran, Iran: Jameh Negar Publications; 2014. p. 58. [In Persian].

El-Sheikh M, El-Ghazaly G. Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt. Indian J Nephrol 2016; 26(6): 398-404.

Esmaili H, Majlessi F, Montazeri A, Sadeghi R, Nedjat S, Zeinali J. Dialysis adequacy and necessity of implement health education models to its promotion in Iran. Int J Med Res Health Sci 2016; 5(10): 116-21.

Abedi Samakoosh M, Aghaie N, Gholami F, Shirzad M, Yosefi E, Teymoorzadeh Baboli M. Assesment dialysis adequacy in hemodialysis patients of Qaemshar Razi Hospital in 2012. J Mazandaran Univ Med Sci 2013; 23(107): 20-7. [In Persian].

Shariati AR, Asayesh H, Nasiri H, Tajbakhsh R, Hesam M, Mollaee E, et al. Comparison of dialysis adequacy in patient's that referred to Golestan province hemodialysis centers. J Health Promot Manag 2012; 1(3): 55-63. [In Persian].

Shasti S, Baba Haji M. The assessment of dialysis adequacy among hemodialysis patients in tehran, city. Ebnesina: 2011; 14(1-2): 23-7. [In Persian].

Rashidi AA, Soleymani AR, Seyedi F. Effects of dialysis frequency on the nutritional status of hemodialysis patients. Koomesh 2009; 10(3): 197-200. [In Persian].

Rashid Farokhi F, Majd Zadeh N, Dehghani M. The evaluation of dietary protein intake by calculation of urea generation rate in chronic dialysis patients in Kerman, 2002. J Kerman Univ Med Sci 2004; 11(4): 188-96. [In Persian].

As'habi A, Nozari B, Tabibi H, Mahdavi-Mazdeh M, Hedayati M, Houshiar Rad A. Prevalence of protein-energy malnutrition and its various types in hemodialysis patients in Tehran, 2008. Iran J Nutr Sci Food Technol 2010; 5(1): 17-28. [In Persian].

Saad MM, El DY, Boumitri C, Rondla C, Moussaly E,

Daoud M, et al. Predictors of quality of life in patients with end-stage renal disease on hemodialysis. Int J Nephrol Renovasc Dis 2015; 8: 119-23.

Machingura PI, Mahiya NM, Chikwasha V. Hypoalbuminaemia in haemodialysis patients at Parirenyatwa group of hospitals and Chitungwiza central hospital. Pan Afr Med J 2015; 21: 79.

Raeisifar A, Torabpour M, Mohsenizad P, Tayebi A, Masoumi M. Dialysis adequacy in patients of abadan hemodialysis center. Iran J Crit Care Nurs 2009; 2(3): 87-90. [In Persian].

Vaz de Souza Freitas AT, Filizola Vaz IM, Ferraz SF, do Rosįrio Gondim Peixoto M, Valente Moraes Campos MI. Prevalence of malnutrition and associated factors in hemodialysis patients. Rev Nutr 2014; 27(3): 257-66.

Hashemi M, Garshad A. Assissing the adequacy of dialysis and some biochemical factors related to it in patient under heamodialysis in dialysis ward of Emam Ali Hospital of Bojnourd. J North Khorasan Univ Med Sci 2012; 4(4): 665-70. [In Persian].

Rashidfarokhi F, Majdzadeh N, Dehghani M. The Evaluation of Dietary Protein Intake by Calculation of Urea Generation Rate in Chronic Dialysis Patients in Kerman, 2002. J Kerman Univ Med Sci 2005; 11(4): 188-96. [In Persian].

Garagarza C, Valente A, Caetano C, Oliveira T, Ponce P, Silva AP. Hypophosphatemia: nutritional status, body composition, and mortality in hemodialysis patients. Int Urol Nephrol 2017; 49(7): 1243-50.

Azar AT, Wahba K, Mohamed AS, Massoud WA. Association between dialysis dose improvement and nutritional status among hemodialysis patients. Am J Nephrol 2007; 27(2): 113-9.

Teixeira Nunes F, de Campos G, Xavier de Paula SM, Merhi VA, Portero-McLellan KC, da Motta DG, et al. Dialysis adequacy and nutritional status of hemodialysis patients. Hemodial Int 2008; 12(1): 45-51.

Stolic R, Trajkovic G, Stolic D, Peric V, Subaric-Gorgieva G. Nutrition parameters as hemodialysis adequacy markers. Hippokratia 2010; 14(3): 193-7.

Song KK, Zhao DL, Wang YD, Wang Y, Sun XF, Miao LN, et al. Analysis of factors associated with death in maintenance hemodialysis patients: a multicenter study in China. Chin Med J (Engl) 2017; 130(8): 885-91.

Mogharab M, Madarshahian F, Rezai N, Mohammadi A. Dialysis adequacy in chronic hemodialysis patients in educational center Vali-Asr in Birjand. J Birjand Univ Med Sci 2010; 17(3): 206-14. Campos

Zafar Mohtashami A, Hadian B, Lashkarara GR, Mahdipanah F. Dialysis adequacy in chronic hemodialysis patients in Shohada Ashayer Hospital, Khorramabad, Lorestan, Iran. Yafteh 2017; 18(4): 13-20.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.