Frequency of Hemodialysis Dependent End Stage Renal Disease Patients ‘At Risk of Malnutrition’ Using Mini Nutritional Assessment Score

Abstract

Background: Malnutrition is a frequent but under-recognized problem among hemodialysis-dependent end-stage renal disease (ESRD) patients and is associated with increased morbidity and mortality. The Mini Nutritional Assessment (MNA) provides a validated tool for detecting malnutrition risk in this population.

Objective: To determine the frequency of hemodialysis-dependent ESRD patients “at risk of malnutrition” using the MNA score and to explore demographic and clinical factors associated with nutritional status.

Material and Methods: A descriptive cross-sectional study was conducted in the dialysis unit and outpatient department of Shifa International Hospital from January to June 2025. A total of 308 patients aged 30–60 years receiving twice-weekly hemodialysis for at least three months were enrolled using non-probability consecutive sampling. Anthropometric measurements and demographic and clinical data were recorded, and nutritional status was assessed with the MNA. Data were analyzed using IBM SPSS version 23. Associations between MNA category and patient characteristics were examined using chi-square tests, and multinomial logistic regression was performed to adjust for potential confounders.

Results: Of the 308 participants, 57.5% (n=177) had normal nutritional status, 27.6% (n=85) were at risk of malnutrition, and 14.9% (n=46) were malnourished. Significant bivariate associations were observed for ongoing infection (p=0.047) and socioeconomic status (p=0.031) with MNA category. After adjustment for age, gender, diabetes status, dialysis duration, and smoking, no covariate except smoking remained significantly associated, and the overall model had limited explanatory power (Nagelkerke R²=0.043).

Conclusion: A substantial proportion of hemodialysis-dependent ESRD patients were at risk of malnutrition or malnourished. Routine nutritional screening and targeted interventions addressing infection control and socioeconomic barriers are warranted.