Nutritional Status, Biochemical Parameters, Dietary Intake, and Factors Associated with Obesity among Hemodialysis Patients in Morocco

Abstract

Background Chronic kidney disease (CKD) is a major global public health concern due to its increasing prevalence, largely driven by diabetes, hypertension, cardiovascular disease, and obesity. Obesity, considered a modifiable risk factor, results from a complex interaction of sociodemographic, nutritional, and biochemical determinants. Objectives This study aimed to assess the nutritional, anthropometric, sociodemographic, and biochemical characteristics of haemodialysis patients, compare nutritional intake between dialysis and non-dialysis days, and examine the associations between obesity and these parameters, as well as their impact on the overall health status of patients with end-stage kidney disease (ESKD). Method and Materials A descriptive cross-sectional study was conducted among 200 haemodialysis patients from three Moroccan cities: Kelaa des Sraghna, El Jadida, and Kénitra. Participants had been receiving haemodialysis treatment for more than three months and had no major disability preventing anthropometric assessment. Results The mean age of participants was 55.24 ± 15.07 years. The findings showed no significant association between obesity and sociodemographic variables, except for region of residence (p = 0.023). A highly significant association was observed between obesity and initial nephropathy (p = 0.000), particularly diabetic (26.5%) and hypertensive nephropathies (33.5%). Obesity was also significantly associated with caloric intake on dialysis and non-dialysis days (p = 0.000), as well as protein intake on dialysis days (p = 0.000) and nondialysis days (p = 0.001). In addition, significant associations were identified between anthropometric and body composition parameters, including BMI, muscle mass, skeletal mass, visceral fat, and body water, and nutritional intake in haemodialysis patients. The results particularly highlighted the role of energy and protein intake in maintaining muscle mass and overall nutritional status, as well as the importance of fluid balance, closely related to total body water and fluid intake. Furthermore, specific dietary components, such as sugar, garlic, and parsley consumption, appeared to be associated with variations in body composition parameters, suggesting the potential influence of qualitative dietary habits beyond quantitative intake alone. Conclusion These findings emphasize the complexity of the interactions between nutrition, body composition, and clinical status in this population and underline the need for individualized nutritional management in hemodialysis patients, integrating energy and protein requirements, fluid intake control, and overall dietary quality. Further longitudinal studies are nevertheless needed to better understand causal relationships and optimize nutritional strategies in this clinical context.

Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1182-1212