Nutritional status of vegetarians on maintenance haemodialysis

ABSTRACT:Aim:  Vegetarian diets have long been thought of as beneficial to health. However, vegetarian diets are often low in protein, which is contradictory to the high protein diet guideline for uraemia patients. The purpose of the study was to investigate the impact of a vegetarian diet on the nutritional status of haemodialysis (HD) patients.Methods:  Patients on chronic HD for over 6 months were included in the study. The normalized protein catabolic rate (nPCR) was used to reflect daily protein intake. Biochemical markers of nutrition, anthropometric parameters, subjective global assessment (SGA) and functional activity of daily living were assessed to evaluate the nutritional status of vegetarians on chronic HD.Results:  Nineteen out of 318 HD patients were vegetarians. The nPCR was lower in the vegetarian group (1.20 ± 0.24 vs 1.10 ± 0.29 g/kg per day, non‐Veg vs Veg, P < 0.05). The serum albumin and prealbumin were similar in vegetarian and non‐vegetarian HD patients. The body mass index (BMI) and mid‐arm muscular circumference (MAMC) were lower in vegetarian patients (P < 0.05). The haematocrit of vegetarians can be maintained at a level similar to that of non‐vegetarian patients but erythropoietin doses needed were higher in vegetarian patients (P < 0.05). The muscle strength evaluated by the hand‐grip test, SGA and activities of daily living were similar in vegetarians and non‐vegetarians.Conclusion:  The present study revealed that HD patients on vegetarian diets might have a smaller BMI, but SGA and function of daily activities were similar to those of the non‐vegetarians. The haematocrit of vegetarians can be maintained with a higher erythropoietin dose.