Varying Association of Nutrient Intakes with Quality of Life in Patients Receiving Different Modes of Dialysis Provisionally Accepted

Yadi Guo¹ Dongling Luo¹ Li Yin¹ Xiaoyan Su² Zhimin Yuan³ Hui Huang¹ Jie Chen^4*

• ¹Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, China
• ²Department of Neurology, Dongguan Tung Wah Hospital, China
• ³Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, China
• ⁴Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, China

Background: Nutrients are crucial for dialysis patients, especially elderly patients. Nutrition-related complications in dialysis patients are often closely related to cardiovascular aging. However, we know little about the effect of different nutrients on the commonly used outcome predictor, health-related quality of life (HRQOL). Therefore, this study investigated the associations between different nutrients and HRQOL among dialysis patients. 
Methods: A cross-sectional study was conducted on 123 dialysis adults at multiple dialysis centers. The Short Form-36 Health Survey (SF-36) assesses HRQOL. Modified quantitative subjective global assessment(MQSGA) evaluates nutritional status. A 3-day dietary record evaluated nutrient intakes. 
Results: Among the 123 participants, 79 received hemodialysis (HD), and 44 were on peritoneal dialysis (PD). Patients with PD had a higher SF-36 score than HD (525 ±136 vs. 375 ± 179, P<0.001). A negative association between nutrition status and HRQOL was observed in HD (regression coefficient β=-17.4, P<0.001) but not in PD (β=-12.3, P=0.07). For HD patients, the nutrition status was negatively correlated with intakes of carbohydrates, fiber, selenium, copper, and Manganese (β=-0.02, P=0.032; β=-0.3, P=0.031; β=-0.1, P=0.006; β=-2.3, P=0.025; β=-1.3, P=0.003, respectively). Their HRQOL was positively associated with calories, fat, niacin, and vitamin E (β = 2.19, P = 0.035; β = 2.4, P = 0.043; β = 8.5, P = 0.044; β = 6.9, P = 0.017, respectively). Conversely, for patients with PD, only vitamin B2 was found to be adversely correlated with their nutritional status (β=-5.2, P=0.037), and increased intakes of vitamin A, vitamin C and fiber (β=0.1, P=0.031; β=0.8, P=0.028; β=15.8, P=0.045, respectively) were associated with a better HRQOL.
Conclusions: The nutritional intake of PD patients and HD patients affects their quality of life differently. Macronutrients significantly impact HRQOL in HD patients, while vitamins have a more substantial impact on PD patients.