Prevalence of Malnutrition and Its Associated Nutritional Challenges and Risk Factors Among Hemodialysis Patients in Sulaimani province: A Cross-Sectional Study

Volume 16 , Issue 1 , July 2026

Authors

Sherzad mahmood 1 ; Dr.Dana Ahmed Sharif 2 ; Mohamad Ibrahim Mohialdeen Gubari Gubari 2

1 university of sulaimani

2 university of sulaimani/College of medicine

DOI logo 10.17656/jsmc.10512

Keywords

Abstract

Background: Malnutrition is a common and serious complication among patients with end-stage renal disease undergoing maintenance hemodialysis, associated with increased morbidity and mortality. Despite its clinical importance, data on nutritional status and challenges among HD patients in Iraq, particularly Sulaimani Province, remain scarce. Objectives: To determine the prevalence of malnutrition among adult hemodialysis patients using validated assessment tools and to identify common nutritional challenges, including dietary adherence, protein-energy wasting, and biochemical abnormalities. Methods: A descriptive cross-sectional study was conducted involving 200 adult HD patients in Sulaimani Province over eight months (December 2024 to July 2025). Nutritional status was assessed using the Subjective Global Assessment (SGA), anthropometric measurements (BMI, mid-upper arm circumference, handgrip strength), dietary surveys, and biochemical markers (serum albumin, C-reactive protein, electrolytes, parathyroid hormone) were collected. Results: The mean age was 58.45 ± 15.23 years, with 54% aged ≥60 years. Males comprised 54% of the sample. The most common causes of kidney failure were unknown (37%), hypertension (25.5%), and diabetes mellitus (25%). Malnutrition was highly prevalent, with 67% classified as mildly to moderately malnourished and 12% severely malnourished by SGA. Anthropometric and functional parameters were lower in malnourished patients (mean BMI 22.3 kg/m², MUAC 23.1 cm, handgrip strength 25.3 kg). Hypoalbuminemia was present in 20.5%, and elevated CRP in 68.5%, indicating a high inflammatory burden. Only 38% adhered to prescribed renal diets, and dietitian involvement was minimal (0.5%). Protein intake was low in 52% of patients. Conclusion: Malnutrition affects nearly 80% of hemodialysis patients in this region

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