#2420 A comparative analysis of food intake according to the degree of dietary compliance among Korean hemodialysis patients
Authors: Kim Jung-Hyun , Ryu Dong-Ryeol , Kim Hyun-Jung , Kyung Min-Sook 
Published: May 2024

Abstract

Background and Aims
Food intake management plays a crucial role in the treatment of hemodialysis (HD) patients. Maintaining a balanced diet involves adequate protein intake, sufficient calorie consumption, and restriction of water, sodium, and potassium intake. This study aims to highlight the significance of balanced dietary management by comparing and analyzing differences in food intake patterns among Korean HD patients based on the levels of dietary adherence. Throughout our analysis, we suggest the importance of balanced food intake management for HD patients.

Method
The data were collected through a survey conducted among 442 HD patients across 18 university hospitals nationwide. The survey employed the dietary adherence and the food intake frequency questionnaire (FFQ). The collected data were analyzed using SPSS 26.0. The analysis method was K-means cluster analysis to classify the degree of dietary adherence into high-adherence and low-adherence. In addition, cross-analysis and independent samples t-test were utilized to compare differences between the groups in demographic characteristics, general health and nutritional status, laboratory data, and food intake frequency.

Results
Gender distribution revealed 257 males (59.4%) and 176 females (40.6%). The age distribution was as follows: 50-64 years old, 179 individuals (40.8%); 30-49 years old, 97 individuals (22.1%); 65–74 years old, 97 individuals (22.1%); 75 years and above, 52 individuals (11.8%). BMI determination resulted in the following order: underweight - normal in 207 people (48.8%); obese - severely obese in 123 people (29.0%); and overweight in 94 people (22.2%). Subjective Global Assessment (SGA) indicated that 296 individuals (73.3%) were in good nutritional status, while 108 individuals (26.7%) were in fair nutritional status. The duration of HD was distributed as follows: 135 patients (32.1%) for 1–3 years, 103 patients (24.5%) for 5–10 years, 82 patients (19.5%) for 3–5 years, and 66 patients (15.7%) for 10 years or longer. The subjects were clustered into two groups based on their dietary compliance: high adherence and low adherence. The dietary compliance scores, on a scale of 22 points, were 13.63 ± 1.475 for the high adherence group and 9.15 ± 1.681 for the low adherence group. In the high adherence group, uric acid (p &lt; 0.01), serum creatinine (p &lt; 0.01), intact PTH (p &lt; 0.01), TIBC (p &lt; 0.05), and glucose (p &lt; 0.05) were significantly lower than those parameters in the low adherence group. The frequency of daily food intake was also analyzed according to the dietary adherence. The high adherence group showed significantly higher frequencies in rice(p &lt; 0.001), white fish(p &lt; 0.05), low-potassium vegetables(p &lt; 0.01), mushrooms(p &lt; 0.01), low-fat milk(p &lt; 0.01), liquid yogurt(p &lt; 0.05) compared to the low adherence group. On the other hand, the high adherence group showed lower consumptions of foods, such as gimbap, bibimbap (p &lt; 0.05), noodle soup(p &lt; 0.01), bread(p &lt; 0.05), fruit juice(p &lt; 0.05), and tea(p &lt; 0.01).

Conclusion
The high-adherence group exhibited significantly satisfactory blood parameters and food intake status, highlighting the pivotal role of dietary compliance. Consequently, adhering to dietary guidelines is essential for ensuring sufficient nutrient intake and overall health among HD patients.