All ETDs from UAB

Advisory Committee Chair

Karen M Meneses

Advisory Committee Members

Andres Azuero

Karen Heaton

Orlando Gutierrez

Julie Locher

Document Type

Dissertation

Date of Award

2014

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Millions of Americans are affected by kidney disease and a large proportion of these individuals require hemodialysis to sustain life. This is a life changing event. The nutritional lifestyle changes associated with hemodialysis may be a key factor to health related outcomes such as depression and health-related quality of life (HRQOL). This study examined the relationship between selected demographic characteristics, nutritional status, measured by serum albumin, normalized protein catabolic rate (nPCR), body mass index (BMI), percent body fat, and self-report dietary protein intake, and HRQOL and depression in patients undergoing chronic hemodialysis. This study also examines the magnitude of correlation between patient-reported dietary protein intake and albumin and nPCR. The sample for this study consisted of 122 hemodialysis patients recruited from four dialysis facilities in the tri-county area of Montgomery, Alabama. Demographic data including age, race, gender, level of education, smoking, alcohol use, co-morbidities, dialysis vintage (length of time on dialysis), and vascular access were collected. HRQOL was assessed using the Kidney Disease Quality of Life-Short Form (KDQOL-SF version 1.3) and depression was measured using the Center for Epidemiological Studies of Depression (CESD) Scale. Data were analyzed using linear regression models and correlational analyses. Smoking, vintage, and level of education were significant predictors of depression scores; however, nutritional status was not relevant to depression in this sample. Level of education, alcohol use, tobacco use, vintage, and diagnosis of diabetes were significant predictors of HRQOL in selected subscales (Effects of Kidney Disease; Burden of Kidney Disease; Physical Component Summary; Mental Component Summary). While albumin and nPCR showed a statistically significant correlation, neither demonstrated a significant relationship with self-reported dietary intake. The findings of this study support current literature and allude to relevancy of relationships between demographic characteristics, nutritional status, and health-related outcomes. Future research is needed to enhance understanding of interrelationships between patient and disease characteristics, nutrition and dialysis patient outcomes. Research should include examining a multidisciplinary approach to comprehensively assessing the nutritional status of hemodialysis patients and exploring nutritional interventions to meet the unique needs of maintenance hemodialysis patients.

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