Nutritional Awareness and Dietary Practices Among Hemodialysis Patients in Omdurman, Sudan: A Cross-Sectional Study

Authors

  • Hanan Alamin Ibrahim
  • Essra I.Babiker
  • Eiman A. Adam
  • Zuhal I.Abdalwahab
  • Azhari A.Mohammed Nour
  • Braa Ahmed Abdelsalam Ali
  • Mohamed Awad Elkarim Mohamed Ibrahim
  • Sara Elkheir Mustafa Fadul
  • Wisal A.M.Babiker
  • Mona Abdelgadir Ahmed abuaqla
  • Sultan Q. Mashnafi

Keywords:

Hemodialysis, Nutritional awareness, Chronic Kidney Disease, Patient Education, and Sudan

Abstract

Background: Chronic kidney disease (CKD) represents a mounting public health challenge, often advancing to end-stage renal disease (ESRD), necessitating maintenance hemodialysis. Optimal dietary management is pivotal in enhancing clinical outcomes among these patients. Nevertheless, in resource-limited settings such as Sudan, inadequate nutritional awareness and restricted access to structured dietary education hinder effective management.

Objective: This study aimed to evaluate the level of nutritional awareness, dietary behaviors, and biochemical profiles among hemodialysis patients in Omdurman, Sudan. Additionally, it explored the impact of socio-demographic and clinical determinants on adherence to dietary recommendations.

Methods: A facility-based cross-sectional study was conducted between September and December 2022 at the Friendship and Ombada Model Hospitals. Data was collected from all eligible hemodialysis patients using structured questionnaires and analyzed with SPSS version 20. Descriptive statistics and frequency distributions were employed to summarize and interpret the findings.

Results: A total of 100 patients participated in the study (64% male; 40% aged above 50 years). The majority reported low to moderate income levels (98%) and limited educational attainment, with nearly half (49%) having received only preschool education. Hypertension emerged as the predominant comorbidity (91%). Although 75% reported adherence to dietary guidelines and 59% had received some form of nutrition-related education, considerable deficiencies were observed particularly in sodium restriction practices, understanding food labels, and avoiding soft drinks. Biochemical assessments indicated elevated serum phosphate (59%) and creatinine levels (97%). Only 42% had a normal BMI, while 45% were underweight. Furthermore, dietary intake was characterized by low consumption of fruits, vegetables, and legumes, alongside inconsistent protein intake.

Conclusion: This study underscores substantial gaps in nutritional knowledge and dietary compliance among hemodialysis patients in Sudan. There is an urgent need for targeted nutrition education, ongoing dietary counseling, and coordinated multidisciplinary strategies to enhance patient outcomes and overall quality of life in this high-risk group

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References

Smith J, Brown A. Epidemiology of chronic kidney disease in older adults: A systematic review. Kidney Int. 2020;97(4):712-722.

Lee S, Kim H. Gender differences in the prevalence and progression of chronic kidney disease. Nephrol Dial Transplant. 2019;34(1):105-112.

Johnson R, Patel M. Socioeconomic status and access to renal replacement therapy. Clin Nephrol. 2018;89(2):101-110.

Ahmed M, Hassan A. Health literacy and its impact on hemodialysis patient outcomes. J Ren Nutr. 2021;31(3):198-205.

Garcia C, Lopez D. Duration of disease and clinical outcomes in dialysis patients. Clin J Am Soc Nephrol. 2017;12(9):1479-1485.

Tanaka Y, et al. Hypertension and cardiovascular risk in dialysis patients. Hypertens Res. 2019;42(8):1173-1180.

Wang L, Chen J. The role of nutritional education in dialysis patient adherence. Nutr Clin Pract. 2020;35(5):812-820.

Thompson K, et al. Physical activity and cardiovascular health in end-stage renal disease. Am J Kidney Dis. 2021;77(1):25-33.

Park S, Kim J. Food safety concerns chronic kidney disease diets. J Ren Nutr. 2018;28(4):253-259.

Nguyen T, et al. Salt intake adherence in dialysis patients: Barriers and solutions. Nephrology. 2020;25(6):495-502.

Roberts C, et al. Impact of sugar-sweetened beverages on hypertension. J Hypertens. 2019;37(2):215-221.

Silva A, et al. Mineral metabolism and phosphate control in hemodialysis patients. Clin Nephrol. 2018;89(6):473-480.

Zhou Y, et al. Hypertension management in dialysis: Current perspectives. Kidney Blood Press Res. 2020;45(4):592-603.

Green D, et al. Dietary patterns and nutrient intake in chronic kidney disease. J Ren Nutr. 2019;29(6):457-464.

Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis. Lancet. 2020;395(10225):709–33.

Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bull World Health Organ. 2018;96(6):414–22.

Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et al. KDOQI clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1–S107.

Clegg DJ, Faul C. Nutrition in patients with chronic kidney disease. Nat Rev Nephrol. 2017;13(9):563–77.

Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, et al. A proposed nomenclature and diagnostic criteria for protein–energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391–8.

Wang Y, Chen X, Liu Y, Qin X, Li H, Li J. Nutritional status and its association with quality of life in patients undergoing hemodialysis. J Ren Nutr. 2021;31(1):41–7.

Kalantar-Zadeh K, Kopple JD. Nutritional management of maintenance hemodialysis patients. In: Daugirdas JT, Blake PG, Ing TS, editors. Handbook of Dialysis. 5th ed. Philadelphia: Wolters Kluwer; 2015. p. 570–90.

National Kidney Foundation. KDOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2000;35(6 Suppl 2):S1–140.

Cupisti A, Brunori G, Di Iorio BR, D'Alessandro C, Pasticci F, Cosola C, et al. Nutritional treatment of advanced CKD: Twenty consensus statements. J Nephrol. 2018;31(4):457–73.

Campbell KL, Carrero JJ, Cuppari L, Kovesdy CP, Lindholm B, Steiber A, et al. Dietitian-delivered nutrition interventions in CKD: a systematic review and meta-analysis. J Am Soc Nephrol. 2017;28(6):1757–69.

Shapiro BB, Leon JB, Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Vitamin D and nutrition in chronic kidney disease. Clin J Am Soc Nephrol. 2011;6(3):513–20.

Chan M, Kelly J, Batterham M, Tapsell L. An intervention to improve dietary compliance in hemodialysis patients: a randomized controlled trial. J Ren Nutr. 2016;26(3):188–95.

Kalantar-Zadeh K, Fouque D, Kopple JD. Outcome research, nutrition, and reverse epidemiology in maintenance dialysis patients. J Ren Nutr. 2015;25(3):292–303.

Stark S, Johansson G, Helmersson G, Clyne N. Dietary knowledge and self-reported adherence in patients on chronic hemodialysis: A Swedish cross-sectional study. Clin Nutr ESPEN. 2021;41:207–13.

Ash S, Campbell KL, MacLaughlin H, McCoy E, Chan M, Anderson K, et al. Evidence-based practice guidelines for the nutritional management of chronic kidney disease. J Ren Nutr. 2019;29(5):333–64.

Rhee CM, Ahmadi SF, Kalantar-Zadeh K. The dual roles of obesity in chronic kidney disease: A review of the current literature. Curr Opin Nephrol Hypertens. 2017;26(3):208–16.

Saleh S, Elshazali OH, Hassan F, Osman M, Osman Y. Nutritional awareness among hemodialysis patients in Khartoum, Sudan. Sudan J Med Sci. 2020;15(4):345–53.

Gheith O, Farouk N, Nampoory N, Halim MA, Al-Otaibi T. Diabetic kidney disease: Worldwide difference of prevalence and risk factors. J Nephropharmacol. 2016;5(1):49–56.

Li M, Zhang X, Zhao M, Zhou Y, Tan X. Effectiveness of group nutritional education on knowledge, attitude and practice among hemodialysis patients. Int J Clin Exp Med. 2017;10(1):751–8.

Chen MF, Chiu YW, Hsu SP, Pai MF, Yang JY, Peng YS, et al. Association of educational status with hemodialysis diet knowledge and dietary phosphorus intake. J Ren Nutr. 2009;19(2):114–20.

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Published

2024-12-22

How to Cite

1.
Ibrahim HA, I.Babiker E, A. Adam E, I.Abdalwahab Z, Nour AA, Abdelsalam Ali BA, et al. Nutritional Awareness and Dietary Practices Among Hemodialysis Patients in Omdurman, Sudan: A Cross-Sectional Study. J Neonatal Surg [Internet]. 2024 Dec. 22 [cited 2026 Feb. 3];13(1):1814-23. Available from: https://jneonatalsurg.com/index.php/jns/article/view/9634

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Original Article