Araştırma Makalesi
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The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients

Yıl 2025, Cilt: 9 Sayı: 3, 323 - 330, 22.12.2025
https://doi.org/10.46332/aemj.1459748

Öz

Purpose: Malnutrition in hemodialysis patients may negatively affect the quality of life and worsen the prognosis of the disease. This study aimed to evaluate the relationship between malnutrition and quality of life in hemodialysis patients.

Materials and Methods: This study was conducted at the Hemodialysis Unit of Ankara Training and Research Hospital, involv-ing 41 patients. The hospital's automation system obtained routine blood biochemical parameters. The questionnaire, which collected general information about the participants, included the Malnutrition-Inflammation Score (MIS) to assess malnutrition and the Quality of Life Scale SF-36 (SF-36) to evaluate quality of life.

Results: The mean MIS of hemodialysis patients was 8.3±2.9, and the MIS of male patients (9.0±2.9) was statistically higher than the MIS of female patients (7.1±2.6) (p=0.042). The mean SF-36 score of hemodialysis patients was 48.3±17.3, and there was no signifcant difference according to gender (p>0.05). There was no significant difference between total quality of life, physical health summary score, and mental health summary score according to MIS categories (p>0.05), but physical function score was statistically higher in those with low MIS (68.9±24.0; 45.9±33.5 p=0.018). A significant negative correlation was found between social function and MIS (r=-0.368, p=0.018). There is a negative correlation between Body Mass Index, mid-upper arm circum-ference, calf circumference, and MIS (r=-0.558, p<0.000; r=-0.650, p<0.000; r=-0.390, p=0.012).

Conclusions: In hemodialysis patients, the MIS can be assessed as an indicator of physical and social functioning in particular. Improving the nutritional status of hemodialysis patients may contribute to a significant improvement in quality of life.

Etik Beyan

This study was approved by the Ethics Committee of SBÜ Ankara Training and Research Hospital (dated 19.12.2019 and numbered E-119/2019).

Kaynakça

  • 1. Rashid I, Bashir A, Tiwari P, D'Cruz S, Jaswal S. Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: an evidence-based systematic review and meta-analysis. Clin Epidemiol Glob Health. 2021;12:100855.
  • 2. Carrero JJ, Thomas F, Nagy K, et al. Global prev-alence of protein-energy wasting in kidney dis-ease: a meta-analysis of contemporary observa-tional studies from the International Society of Renal Nutrition and Metabolism. J Ren Nutr. 2018;28(6):380-392.
  • 3. Iorember FM. Malnutrition in chronic kidney disease. Front Pediatr. 2018;6:161.
  • 4. Aziz G, Ebrahim Z, Esau N, Bazezew MM. As-sessment criteria to diagnose malnutrition (un-dernutrition and overnutrition) in hemodialysis patients. J Ren Nutr. 2024;34(2):123-130.
  • 5. Jones CH, Wolfenden RC, Wells LM. Is subjec-tive global assessment a reliable measure of nu-tritional status in hemodialysis? J Ren Nutr. 2004;14(1):26-30.
  • 6. Lim LM, Kuo HT, Chao YL, et al. Malnutrition-Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients. 2024;16(23):4014.
  • 7. Bilgic A, Akgul A, Sezer S, Arat Z, Ozdemir FN, Haberal M. Nutritional status and depression, sleep disorder, and quality of life in hemodialy-sis patients. J Ren Nutr. 2007;17(6):381-382.
  • 8. Rambod M, Bross R, Zitterkoph J, et al. Associa-tion of malnutrition-inflammation score with quality of life and mortality in hemodialysis pa-tients: a 5-year prospective cohort study. Am J Kidney Dis. 2009;53(2):298-309.
  • 9. Afsar B. Nutrition and quality of life in hemodi-alysis patients. Turkiye Klinikleri J Nephrol-Special Topics. 2015;8(3):30-34.
  • 10. Cepeda Marte JL, Javier A, Ruiz-Matuk C, Pauli-no-Ramirez R. Quality of life and nutritional sta-tus in diabetic patients on hemodialysis. Diabetes Metab Syndr. 2019;13(1):576-580.
  • 11. Güler S, Budakoğlu İ, Besler T, Pekcan G, Tü-rkyılmaz AS, Çıngı H, et al. Methodology of na-tional Turkey nutrition and health survey (TNHS) 2010. Med J Islam World Acad Sci. 2014;109(1565):1–23.
  • 12. Kaysen GA, Dubin JA, Müller HG, et al. Rela-tionships among inflammation, nutrition, and physiologic mechanisms establishing albumin levels in hemodialysis patients. Kidney Int. 2002;61(6):2240-2249.
  • 13. Tander B, Durmus D, Akyol Y, Canturk F. Quali-ty of life, pain, and depression in patients with hemodialysis. Rheumatism. 2008;23(3):72-76.
  • 14. Borges MC, Vogt BP, Martin LC, Caramori JC. Malnutrition inflammation score cut-off predict-ing mortality in maintenance hemodialysis pa-tients. Clin Nutr ESPEN. 2017;17:63-67.
  • 15. Ware JE, Sherbourne CD. The MOS 36-item short form health survey (SF-36). Med Care. 1992;30:473-483.
  • 16. Pinar R. A new concept in health research: quali-ty of life, examination of the validity and reliabil-ity of a quality of life scale in chronic diseases. Nurs Bull. 1995;9(38):85-95.
  • 17. Chen J, Peng H, Zhang K, et al. The insufficiency intake of dietary micronutrients associated with malnutrition-inflammation score in hemodialysis population. PLoS One. 2013;8(6):66841.
  • 18. Zhang L, Zhang S, Tang X. The association be-tween lifestyle and all-cause mortality in patients undergoing maintenance hemodialysis: a 3-year prospective, observational study. J Multidiscip Healthc. 2025;1721-1729.
  • 19. Yavuz R, Yavuz D, Altunoglu A, et al. Depres-sion, inflammation, and social support in hemo-dialysis patients. J Clin Anal Med. 2015;6(6):801-805.
  • 20. Brandão da Cunha Bandeira S, Cansanção K, Pe-reira de Paula T, Peres WAF. Evaluation of the prognostic significance of the malnutrition-inflammation score in hemodialysis patients. Clin Nutr ESPEN. 2020;35:109-115.
  • 21. Bató A, Brodszky V, Rencz F. Development of updated population norms for the SF-36 for Hungary and comparison with 1997–1998 norms. Health Qual Life Outcomes. 2025;23(1):14.
  • 22. Zhu C, Meng X, Zhang D, Wang H. Quality of life and its influencing factors in maintenance hemodialysis patients. J Shenyang Med Coll. 2024;26(6):606-612.
  • 23. Bayoumi M, Al Harbi A, Al Suwaida A, et al. Predictors of quality of life in hemodialysis pa-tients. Saudi J Kidney Dis Transpl. 2013;24(2):254-259.
  • 24. Zouari L, Omri S, Turki S, et al. Quality of life in chronic hemodialysis patients:about 71 cases. Tunis Med. 2016;94(1):40-45.
  • 25. Wang W, Liang S, Guo X, Wang Y, Chen X, Cai G. Association of the malnutrition-inflammation score with physical function and functional disa-bility in elderly patients with chronic kidney dis-ease. Asia Pac J Clin Nutr. 2023;32(1):57-62.
  • 26. Lopes MB, Silva LF, Lopes GB, et al. Additional contribution of the malnutrition-inflammation score to predict mortality and patient-reported outcomes as compared with its components in a cohort of African descent hemodialysis patients. J Ren Nutr. 2017;27(1):45-52.
  • 27. Ibrahim S, El Salamony O. Depression, quality of life, and malnutrition-inflammation scores in hemodialysis patients. Am J Nephrol. 2008;28(5):784-791.
  • 28. Sohrabi Z, Eftekhari MH, Eskandari MH, Re-zaeianzadeh A, Sagheb MM. Malnutrition-inflammation score and quality of life in hemodi-alysis patients: is there any correlation? Nephrourol Mon. 2015;7(3):27445.
  • 29. Wang WL, Liang S, Zhu FL, Liu JQ, Chen XM, Cai GY. Association of the malnutrition-inflammation score with anthropometry and body composition measurements in patients with chronic kidney disease. Ann Palliat Med. 2019;8(5):596-603.
  • 30. Gencer F, Yıldıran H, Erten Y. Association of malnutrition-inflammation score with anthropo-metric parameters, depression, and quality of life in hemodialysis patients. J Am Coll Nutr. 2019;38(5):457-462.
  • 31. Santin F, Rodrigues J, Brito FB, Avesani CM. Performance of subjective global assessment and malnutrition-inflammation score for monitoring the nutritional status of older adults on hemodi-alysis. Clin Nutr. 2018;37(2):604-611.
  • 32. Aoyagi T, Naka H, Miyaji K, Hayakawa K, Ishi-kawa H, Hata M. Body mass index for chronic hemodialysis patients: stable hemodialysis and mortality. Int J Urol. 2001;8(8):71-75.
  • 33. Aggarwal HK, Jain D, Chauda R, Bhatia S, Sehgal R. Assessment of malnutrition-inflammation score in different stages of chronic kidney dis-ease. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2018;39(2-3):51-61.
  • 34. Ko YT, Lin YL, Kuo CH, Lai YH, Wang CH, Hsu BG. Low serum leptin levels are associated with malnutrition status according to malnutrition-inflammation score in patients undergoing chron-ic hemodialysis. Hemodial Int. 2020;24(2):221-227.

Hemodiyaliz Hastalarında Yaşam Kalitesi ve Beslenme Durumu Arasındaki İlişki

Yıl 2025, Cilt: 9 Sayı: 3, 323 - 330, 22.12.2025
https://doi.org/10.46332/aemj.1459748

Öz

Amaç: Hemodiyaliz hastalarında malnütrisyon, yaşam kalitesini olumsuz etkileyerek hastalığın prognozunu kötüleştirebilir. Bu çalışmada hemodiyaliz hastalarında malnütrisyon ile yaşam kalitesi arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.

Araçlar ve Yöntem: Bu kesitsel ve tanımlayıcı çalışma, Temmuz - Ekim 2019 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi Hemodiyaliz Ünitesinde, en az altı aydır haftada iki veya üç kez diyalize giren 41 hasta üzerinde yürütülmüştür. He-modiyaliz hastalarının rutin kan biyokimyasal parametreleri hastane otomasyon sisteminden temin edilmiştir. Bireylerin genel bilgilerini sorgulayan anket, yetersiz beslenmeyi belirlemek için Malnütrisyon-İnflamasyon Skoru (MIS), yaşam kalitesini belir-lemek için Yaşam Kalitesi Ölçeği SF-36 (SF-36) araştırmacı tarafından uygulanmış ve antropometrik ölçümler standartlara uygun olarak alınmıştır. İstatistiksel analiz SPSS 21.0 kullanılarak yapılmış ve istatistiksel anlamlılık p<0.05 olarak belirlenmiştir.

Bulgular: Hemodiyaliz hastalarının MIS ortalaması 8.3±2.9 olup, erkek hastaların MIS'i (9.0±2.9) kadın hastaların MIS'inden (7.1±2.6) istatistiksel olarak daha yüksektir (p=0.042). Hemodiyaliz hastalarının ortalama SF-36 skoru 48.3±17.3'dir ve cinsiyete göre anlamlı fark yoktur (p>0.05). MIS kategorilerine göre toplam yaşam kalitesi, fiziksel sağlık özet puanı ve mental sağlık özet puanı arasında anlamlı fark yoktur (p>0.05), ancak MIS düşük olanlarda fiziksel fonksiyon puanı istatistiksel olarak daha yüksektir (68.9±24.0; 45.9±33.5 p=0.018). Sosyal işlev ile MIS arasında anlamlı bir negatif korelasyon bulunmuştur (r=-0.368, p=0.018). Beden kütle İndeksi, üst orta kol çevresi, baldır çevresi ve MIS arasında negatif korelasyon vardır (r=-0.558, p<0.000; r=-0.650, p<0.000; r=-0.390, p=0.012).

Sonuç: Hemodiyaliz hastalarında, Malnütrisyon-İnflamasyon Skoru, özellikle fiziksel ve sosyal işlevin bir göstergesi olarak değerlendirilebilir. Hemodiyaliz hastalarının beslenme durumunun iyileştirilmesi, yaşam kalitesinin önemli ölçüde gelişmesine katkı sağlayabilir.

Etik Beyan

Bu çalışma SBÜ Ankara Eğitim ve Araştırma Hastanesi Etik Kurulu tarafından 19.12.2019 tarih ve E-119/2019 sayılı kararla onaylanmıştır.

Kaynakça

  • 1. Rashid I, Bashir A, Tiwari P, D'Cruz S, Jaswal S. Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: an evidence-based systematic review and meta-analysis. Clin Epidemiol Glob Health. 2021;12:100855.
  • 2. Carrero JJ, Thomas F, Nagy K, et al. Global prev-alence of protein-energy wasting in kidney dis-ease: a meta-analysis of contemporary observa-tional studies from the International Society of Renal Nutrition and Metabolism. J Ren Nutr. 2018;28(6):380-392.
  • 3. Iorember FM. Malnutrition in chronic kidney disease. Front Pediatr. 2018;6:161.
  • 4. Aziz G, Ebrahim Z, Esau N, Bazezew MM. As-sessment criteria to diagnose malnutrition (un-dernutrition and overnutrition) in hemodialysis patients. J Ren Nutr. 2024;34(2):123-130.
  • 5. Jones CH, Wolfenden RC, Wells LM. Is subjec-tive global assessment a reliable measure of nu-tritional status in hemodialysis? J Ren Nutr. 2004;14(1):26-30.
  • 6. Lim LM, Kuo HT, Chao YL, et al. Malnutrition-Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients. 2024;16(23):4014.
  • 7. Bilgic A, Akgul A, Sezer S, Arat Z, Ozdemir FN, Haberal M. Nutritional status and depression, sleep disorder, and quality of life in hemodialy-sis patients. J Ren Nutr. 2007;17(6):381-382.
  • 8. Rambod M, Bross R, Zitterkoph J, et al. Associa-tion of malnutrition-inflammation score with quality of life and mortality in hemodialysis pa-tients: a 5-year prospective cohort study. Am J Kidney Dis. 2009;53(2):298-309.
  • 9. Afsar B. Nutrition and quality of life in hemodi-alysis patients. Turkiye Klinikleri J Nephrol-Special Topics. 2015;8(3):30-34.
  • 10. Cepeda Marte JL, Javier A, Ruiz-Matuk C, Pauli-no-Ramirez R. Quality of life and nutritional sta-tus in diabetic patients on hemodialysis. Diabetes Metab Syndr. 2019;13(1):576-580.
  • 11. Güler S, Budakoğlu İ, Besler T, Pekcan G, Tü-rkyılmaz AS, Çıngı H, et al. Methodology of na-tional Turkey nutrition and health survey (TNHS) 2010. Med J Islam World Acad Sci. 2014;109(1565):1–23.
  • 12. Kaysen GA, Dubin JA, Müller HG, et al. Rela-tionships among inflammation, nutrition, and physiologic mechanisms establishing albumin levels in hemodialysis patients. Kidney Int. 2002;61(6):2240-2249.
  • 13. Tander B, Durmus D, Akyol Y, Canturk F. Quali-ty of life, pain, and depression in patients with hemodialysis. Rheumatism. 2008;23(3):72-76.
  • 14. Borges MC, Vogt BP, Martin LC, Caramori JC. Malnutrition inflammation score cut-off predict-ing mortality in maintenance hemodialysis pa-tients. Clin Nutr ESPEN. 2017;17:63-67.
  • 15. Ware JE, Sherbourne CD. The MOS 36-item short form health survey (SF-36). Med Care. 1992;30:473-483.
  • 16. Pinar R. A new concept in health research: quali-ty of life, examination of the validity and reliabil-ity of a quality of life scale in chronic diseases. Nurs Bull. 1995;9(38):85-95.
  • 17. Chen J, Peng H, Zhang K, et al. The insufficiency intake of dietary micronutrients associated with malnutrition-inflammation score in hemodialysis population. PLoS One. 2013;8(6):66841.
  • 18. Zhang L, Zhang S, Tang X. The association be-tween lifestyle and all-cause mortality in patients undergoing maintenance hemodialysis: a 3-year prospective, observational study. J Multidiscip Healthc. 2025;1721-1729.
  • 19. Yavuz R, Yavuz D, Altunoglu A, et al. Depres-sion, inflammation, and social support in hemo-dialysis patients. J Clin Anal Med. 2015;6(6):801-805.
  • 20. Brandão da Cunha Bandeira S, Cansanção K, Pe-reira de Paula T, Peres WAF. Evaluation of the prognostic significance of the malnutrition-inflammation score in hemodialysis patients. Clin Nutr ESPEN. 2020;35:109-115.
  • 21. Bató A, Brodszky V, Rencz F. Development of updated population norms for the SF-36 for Hungary and comparison with 1997–1998 norms. Health Qual Life Outcomes. 2025;23(1):14.
  • 22. Zhu C, Meng X, Zhang D, Wang H. Quality of life and its influencing factors in maintenance hemodialysis patients. J Shenyang Med Coll. 2024;26(6):606-612.
  • 23. Bayoumi M, Al Harbi A, Al Suwaida A, et al. Predictors of quality of life in hemodialysis pa-tients. Saudi J Kidney Dis Transpl. 2013;24(2):254-259.
  • 24. Zouari L, Omri S, Turki S, et al. Quality of life in chronic hemodialysis patients:about 71 cases. Tunis Med. 2016;94(1):40-45.
  • 25. Wang W, Liang S, Guo X, Wang Y, Chen X, Cai G. Association of the malnutrition-inflammation score with physical function and functional disa-bility in elderly patients with chronic kidney dis-ease. Asia Pac J Clin Nutr. 2023;32(1):57-62.
  • 26. Lopes MB, Silva LF, Lopes GB, et al. Additional contribution of the malnutrition-inflammation score to predict mortality and patient-reported outcomes as compared with its components in a cohort of African descent hemodialysis patients. J Ren Nutr. 2017;27(1):45-52.
  • 27. Ibrahim S, El Salamony O. Depression, quality of life, and malnutrition-inflammation scores in hemodialysis patients. Am J Nephrol. 2008;28(5):784-791.
  • 28. Sohrabi Z, Eftekhari MH, Eskandari MH, Re-zaeianzadeh A, Sagheb MM. Malnutrition-inflammation score and quality of life in hemodi-alysis patients: is there any correlation? Nephrourol Mon. 2015;7(3):27445.
  • 29. Wang WL, Liang S, Zhu FL, Liu JQ, Chen XM, Cai GY. Association of the malnutrition-inflammation score with anthropometry and body composition measurements in patients with chronic kidney disease. Ann Palliat Med. 2019;8(5):596-603.
  • 30. Gencer F, Yıldıran H, Erten Y. Association of malnutrition-inflammation score with anthropo-metric parameters, depression, and quality of life in hemodialysis patients. J Am Coll Nutr. 2019;38(5):457-462.
  • 31. Santin F, Rodrigues J, Brito FB, Avesani CM. Performance of subjective global assessment and malnutrition-inflammation score for monitoring the nutritional status of older adults on hemodi-alysis. Clin Nutr. 2018;37(2):604-611.
  • 32. Aoyagi T, Naka H, Miyaji K, Hayakawa K, Ishi-kawa H, Hata M. Body mass index for chronic hemodialysis patients: stable hemodialysis and mortality. Int J Urol. 2001;8(8):71-75.
  • 33. Aggarwal HK, Jain D, Chauda R, Bhatia S, Sehgal R. Assessment of malnutrition-inflammation score in different stages of chronic kidney dis-ease. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2018;39(2-3):51-61.
  • 34. Ko YT, Lin YL, Kuo CH, Lai YH, Wang CH, Hsu BG. Low serum leptin levels are associated with malnutrition status according to malnutrition-inflammation score in patients undergoing chron-ic hemodialysis. Hemodial Int. 2020;24(2):221-227.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Nefroloji
Bölüm Araştırma Makalesi
Yazarlar

Fatmanur Hümeyra Zengin 0000-0003-1586-5878

Eda Mert 0000-0002-3104-3631

Murat Duranay 0000-0002-2893-4484

Gönderilme Tarihi 27 Mart 2024
Kabul Tarihi 17 Haziran 2025
Yayımlanma Tarihi 22 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 3

Kaynak Göster

APA Zengin, F. H., Mert, E., & Duranay, M. (2025). The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients. Ahi Evran Medical Journal, 9(3), 323-330. https://doi.org/10.46332/aemj.1459748
AMA Zengin FH, Mert E, Duranay M. The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients. Ahi Evran Medical Journal. Aralık 2025;9(3):323-330. doi:10.46332/aemj.1459748
Chicago Zengin, Fatmanur Hümeyra, Eda Mert, ve Murat Duranay. “The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients”. Ahi Evran Medical Journal 9, sy. 3 (Aralık 2025): 323-30. https://doi.org/10.46332/aemj.1459748.
EndNote Zengin FH, Mert E, Duranay M (01 Aralık 2025) The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients. Ahi Evran Medical Journal 9 3 323–330.
IEEE F. H. Zengin, E. Mert, ve M. Duranay, “The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients”, Ahi Evran Medical Journal, c. 9, sy. 3, ss. 323–330, 2025, doi: 10.46332/aemj.1459748.
ISNAD Zengin, Fatmanur Hümeyra vd. “The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients”. Ahi Evran Medical Journal 9/3 (Aralık2025), 323-330. https://doi.org/10.46332/aemj.1459748.
JAMA Zengin FH, Mert E, Duranay M. The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients. Ahi Evran Medical Journal. 2025;9:323–330.
MLA Zengin, Fatmanur Hümeyra vd. “The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients”. Ahi Evran Medical Journal, c. 9, sy. 3, 2025, ss. 323-30, doi:10.46332/aemj.1459748.
Vancouver Zengin FH, Mert E, Duranay M. The Relationship Between Quality of Life and Nutritional Status in Hemodialysis Patients. Ahi Evran Medical Journal. 2025;9(3):323-30.

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