Prevalence of Malnutrition Among Patients Undergoing Dialysis in Sana'a Yemen

Authors

DOI:

https://doi.org/10.58963/qausrj.v30i30.329

Keywords:

* Malnutrition , * Dialysis , * Chronic Kidney Disease , * Yemen , * Nutritional Assessment , * Subjective Global Assessment , * Risk Factors

Abstract

Malnutrition is a frequent and serious complication among patients undergoing dialysis, contributing substantially to increased morbidity and mortality. In Yemen, limited evidence exists regarding the nutritional status of dialysis patients, hindering the design of effective nutritional interventions. This study aimed to determine the prevalence of malnutrition among hemodialysis patients in selected hospitals in Sana’a, Yemen, assess their nutritional status using validated tools, and identify key factors associated with malnutrition to inform targeted clinical strategies.

A cross-sectional descriptive study was conducted over three months at Al-Thawra and Al-Motawakel hospitals. The study included 103 patients aged 12 years and above who had been receiving hemodialysis for at least three months. Nutritional status was evaluated using the Subjective Global Assessment (SGA), while sociodemographic, clinical, and lifestyle characteristics were collected through structured questionnaires. Data were analyzed using SPSS version 26, with chi-square tests applied to examine associations between nutritional status and selected variables (p<0.05).

Results showed that 38.8% of participants were malnourished, 33.0% were at risk, and 28.2% were well-nourished. Malnutrition was more prevalent among younger and middle-aged adults, individuals with lower educational levels, and those reporting short sleep duration (2–4 hours; p=0.003). No significant associations were observed with gender or dialysis frequency. These findings are consistent with international reports highlighting the multifactorial nature of malnutrition among dialysis patients.

Malnutrition is highly prevalent among Yemeni dialysis patients, underscoring the need for routine nutritional assessment and targeted interventions to enhance dietary management, clinical outcomes, and overall quality of life.

Downloads

Download data is not yet available.

Author Biographies

  • Mohammed Alsebaeai, Ibb University, Lebanese International University

    Department of Food Science and Technology, Faculty of Agriculture and food sciences, Ibb  University, Yemen.
    Department of Therapeutic Nutrition, The School of Pharmacy and Medical Sciences, International Lebanese University, Sana’a, Yemen

  • Fatima Saeed, Lebanese International University

    Department of Therapeutic Nutrition, The School of Pharmacy and Medical Sciences, International Lebanese University, Sana’a, Yemen

  • Sumaia Al-Eryani, Lebanese International University

    Department of Therapeutic Nutrition, The School of Pharmacy and Medical Sciences, International Lebanese University, Sana’a, Yemen

  • Ala'a Al-Eryani, Lebanese International University

    Department of Therapeutic Nutrition, The School of Pharmacy and Medical Sciences, International Lebanese University, Sana’a, Yemen

  • Mentallah Al-Badri, Lebanese International University

    Department of Therapeutic Nutrition, The School of Pharmacy and Medical Sciences, International Lebanese University, Sana’a, Yemen

References

Francis, A., Harhay, M. N., Ong, A. C. M., Tummalapalli, S. L., Ortiz, A., Fogo, A. B., Fliser, D., Roy-Chaudhury, P., Fontana, M., Nangaku, M., Wanner, C., Malik, C., Hradsky, A., Adu, D., Bavanandan, S., Cusumano, A., Sola, L., Ulasi, I., Jha, V.,…International Society of, Nephrology. (2024). Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol, 20(7), 473–485. https://doi.org/10.1038/s41581-024-00820-6

Collins, A. J., Foley, R. N., Herzog, C., Chavers, B., Gilbertson, D., Herzog, C., Ishani, A., Johansen, K., Kasiske, B., Kutner, N., Liu, J., St Peter, W., Ding, S., Guo, H., Kats, A., Lamb, K., Li, S., Li, S., Roberts, T.,…Agodoa, L. (2013). US Renal Data System 2012 Annual Data Report. Am J Kidney Dis, 61(1 Suppl 1), A7, e1–476. https://doi.org/10.1053/j.ajkd.2012.11.031

Dukkipati, R., & Kopple, J. D. (2009). Causes and prevention of protein-energy wasting in chronic kidney failure. Semin Nephrol, 29(1), 39–49. https://doi.org/10.1016/j.semnephrol.2008.10.006

de Mutsert, R., Grootendorst, D. C., Boeschoten, E. W., Brandts, H., van Manen, J. G., Krediet, R. T., Dekker, F. W., & Netherlands Cooperative Study on the Adequacy of Dialysis-2 Study, Group. (2009). Subjective global assessment of nutritional status is strongly associated with mortality in chronic dialysis patients. Am J Clin Nutr, 89(3), 787–793. https://doi.org/10.3945/ajcn.2008.26970

Neyra, R., Chen, K. Y., Sun, M., Shyr, Y., Hakim, R. M., & Ikizler, T. A. (2003). Increased resting energy expenditure in patients with end-stage renal disease. JPEN J Parenter Enteral Nutr, 27(1), 36–42. https://doi.org/10.1177/014860710302700136

Chung, Sungjin, Koh, Eun Sil, Shin, Seok Joon, & Park, Cheol Whee. (2012). Malnutrition in patients with chronic kidney disease. Open Journal of Internal Medicine, 02(02), 89–99. https://doi.org/10.4236/ojim.2012.22018

Carrero, J. J., Qureshi, A. R., Axelsson, J., Yilmaz, M. I., Rehnmark, S., Witt, M. R., Barany, P., Heimburger, O., Suliman, M. E., Alvestrand, A., Lindholm, B., & Stenvinkel, P. (2007). Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med, 262(6), 690–701. https://doi.org/10.1111/j.1365-2796.2007.01865.x

Price, S. R., Gooch, J. L., Donaldson, S. K., & Roberts-Wilson, T. K. (2010). Muscle atrophy in chronic kidney disease results from abnormalities in insulin signaling. J Ren Nutr, 20(5 Suppl), S24–28. https://doi.org/10.1053/j.jrn.2010.05.007

de Brito-Ashurst, I., Varagunam, M., Raftery, M. J., & Yaqoob, M. M. (2009). Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol, 20(9), 2075–2084. https://doi.org/10.1681/ASN.2008111205

Wang, H., & Ye, J. (2015). Regulation of energy balance by inflammation: common theme in physiology and pathology. Rev Endocr Metab Disord, 16(1), 47–54. https://doi.org/10.1007/s11154-014-9306-8

Pupim, L. B., Heimburger, O., Qureshi, A. R., Ikizler, T. A., & Stenvinkel, P. (2005). Accelerated lean body mass loss in incident chronic dialysis patients with diabetes mellitus. Kidney Int, 68(5), 2368–2374. https://doi.org/10.1111/j.1523-1755.2005.00699.x

Kurella Tamura, M., Covinsky, K. E., Chertow, G. M., Yaffe, K., Landefeld, C. S., & McCulloch, C. E. (2009). Functional status of elderly adults before and after initiation of dialysis. N Engl J Med, 361(16), 1539–1547. https://doi.org/10.1056/NEJMoa0904655

Jassal, S. V., Karaboyas, A., Comment, L. A., Bieber, B. A., Morgenstern, H., Sen, A., Gillespie, B. W., De Sequera, P., Marshall, M. R., Fukuhara, S., Robinson, B. M., Pisoni, R. L., & Tentori, F. (2016). Functional Dependence and Mortality in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis, 67(2), 283–292. https://doi.org/10.1053/j.ajkd.2015.09.024

Ikizler, T. A., Cano, N. J., Franch, H., Fouque, D., Himmelfarb, J., Kalantar-Zadeh, K., Kuhlmann, M. K., Stenvinkel, P., TerWee, P., Teta, D., Wang, A. Y., Wanner, C., International Society of Renal, Nutrition, & Metabolism. (2013). Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int, 84(6), 1096–1107. https://doi.org/10.1038/ki.2013.147

Alsebaeai, Mohammed, Karthami, Reham, Ayd, Nadia, Moshta, Haneen, Haidarah, Haidarah, Al-Sayaghi, Hadeel, Othman, Entesar, Botily, Basema, Alnuzaili, Asma, Almazba, Amat, Al-Seraji, Soha, & Al-Shaibi, Wafa'a. (2025). Stunting Status and Associated Risk Factors among Some Primary School Children in Sana'a City, Yemen. Queen Arwa University Journal, 29(29), 10. https://doi.org/10.58963/qausrj.v29i29.313

Alsebaeai, Mohammed, Al-Rahbi, Lutf, Taher, Abdo, Sharaf El-Din, Abeer, Al-Jadi, Noha, Alwajeh, Nada, Almigdad, Nada, Alasadi, Maram, Abdulmoghni, Johaina, Abutaleb, Huda, Alazzani, Ethar, Algaal, Doaa, Alansi, Amani, Al-Absi, Marwa, & Alnwar, Yasmin. (2025). Nutrition Status and Associated Risk Factors Among Children in Orphanages in Sanaa, Yemen. Queen Arwa University Journal, 29(29), 9. https://doi.org/10.58963/qausrj.v29i29.309

Alsebaeai, Mohammed, Al-Qubati, Shehab, Isskandar, Sarah, Juman, Haifa, Alhalhali, Shaima, Alosheeb, Mesk, Al Badani, Sumia, Al-duais, Ala'a, & Aklaan, Shaimaa. (2025). The Prevalence Rate of Pica Disorder and its Nutritional and Non-nutritional Risk Factors among Pregnant Woman in Sana’a – Yemen. International Journal of Innovative Science and Research Technology, 481–487. https://doi.org/10.38124/ijisrt/25mar207

Hensrud, D. D. (1999). Nutrition screening and assessment. Med Clin North Am, 83(6), 1525–1546. https://doi.org/10.1016/s0025-7125(05)70178-4

Detsky, A. S., McLaughlin, J. R., Baker, J. P., Johnston, N., Whittaker, S., Mendelson, R. A., & Jeejeebhoy, K. N. (1987). What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr, 11(1), 8–13. https://doi.org/10.1177/014860718701100108

Alsuwaida, A. O., Farag, Y. M., Al Sayyari, A. A., Mousa, D., Alhejaili, F., Al-Harbi, A., Housawi, A., Mittal, B. V., & Singh, A. K. (2010). Epidemiology of chronic kidney disease in the Kingdom of Saudi Arabia (SEEK-Saudi investigators) - a pilot study. Saudi J Kidney Dis Transpl, 21(6), 1066–1072. https://www.ncbi.nlm.nih.gov/pubmed/21060175

Ebazaway, MohammedM, Ahmed, HassanA, Yassine, YassineS, & Tawafe, AhmedR. (2015). Epidemiological study of patients on regular haemodialysis at the Kafer El-Shakh Governorate, Egypt. Menoufia Medical Journal, 28(2), 267. https://doi.org/10.4103/1110-2098.163858

Pippias, M., Stel, V. S., Abad Diez, J. M., Afentakis, N., Herrero-Calvo, J. A., Arias, M., Tomilina, N., Bouzas Caamano, E., Buturovic-Ponikvar, J., Cala, S., Caskey, F. J., Castro de la Nuez, P., Cernevskis, H., Collart, F., Alonso de la Torre, R., Garcia Bazaga Mde, L., De Meester, J., Diaz, J. M., Djukanovic, L.,…Jager, K. J. (2015). Renal replacement therapy in Europe: a summary of the 2012 ERA-EDTA Registry Annual Report. Clin Kidney J, 8(3), 248–261. https://doi.org/10.1093/ckj/sfv014

Al Ismaili, F., Al Salmi, I., Al Maimani, Y., Metry, A. M., Al Marhoobi, H., Hola, A., & Pisoni, R. L. (2017). Epidemiological Transition of End-Stage Kidney Disease in Oman. Kidney Int Rep, 2(1), 27–35. https://doi.org/10.1016/j.ekir.2016.09.001

Rizvi, S. A., & Anwar Naqvi, S. A. (1996). Renal replacement therapy in pakistan. Saudi J Kidney Dis Transpl, 7(4), 404–408. https://www.ncbi.nlm.nih.gov/pubmed/18417773

Taylor, D. M., Fraser, S., Dudley, C., Oniscu, G. C., Tomson, C., Ravanan, R., Roderick, P., & investigators, Attom. (2018). Health literacy and patient outcomes in chronic kidney disease: a systematic review. Nephrol Dial Transplant, 33(9), 1545–1558. https://doi.org/10.1093/ndt/gfx293

Freitas, Ana Tereza Vaz de Souza, Vaz, Inaiana Marques Filizola, Ferraz, Sanzia Francisca, Peixoto, Maria do Rosário Gondim, & Campos, Marta Isabel Valente Moraes. (2014). Prevalence of malnutrition and associated factors in hemodialysis patients. Revista de Nutrição, 27(3), 357–366. https://doi.org/10.1590/1415-52732014000300009

Ghorbani, Ali, Hayati, Fatemeh, Karandish, Majid, & Sabzali, Soudabeh. (2020). The prevalence of malnutrition in hemodialysis patients. Journal of Renal Injury Prevention, 9(2), e15–e15. https://doi.org/10.34172/jrip.2020.15

Tayyem, R. F., & Mrayyan, M. T. (2008). Assessing the prevalence of malnutrition in chronic kidney disease patients in jordan. J Ren Nutr, 18(2), 202–209. https://doi.org/10.1053/j.jrn.2007.10.001

Badrasawi, M., Zidan, S., Sharif, I., Qaisiyha, J., Ewaida, S., Jaradat, T., & Samamra, Y. (2021). Prevalence and correlates of malnutrition among hemodialysis patients at hebron governmental hospital, Palestine: cross-sectional study. BMC Nephrol, 22(1), 214. https://doi.org/10.1186/s12882-021-02413-y

Reza, Hasan Mahfuz, Shuvo, Suvasish Das, & Ahmad, Tanvir. (2018). Assessing the prevalence of malnutrition in chronic kidney disease patients undergoing hemodialysis in Kushtia District, Bangladesh. Nutrition & Food Science, 48(1), 150–164. https://doi.org/10.1108/nfs-05-2017-0103

Liman, H. M., Anteyi, E. A., & Oviasu, E. (2015). Prevalence of malnutrition in chronic kidney disease: A study of patients in a tertiary Hospital in Nigeria. Sahel Medical Journal, 18(5), 8. https://doi.org/10.4103/1118-8561.149496

Pham Thi Lan, A., Truong Thanh, A., Luong Ngoc, Q., Pham Nhat, T., & Doan Duy, T. (2024). Prevalence and factors associated with malnutrition among hemodialysis patients in a single hemodialysis center in Vietnam: A cross-sectional study. Medicine (Baltimore), 103(14), e37679. https://doi.org/10.1097/MD.0000000000037679

Downloads

Published

2025-12-31

How to Cite

Alsebaeai, M., Saeed, F., Al-Eryani, S., Al-Eryani, A., & Al-Badri, M. (2025). Prevalence of Malnutrition Among Patients Undergoing Dialysis in Sana’a Yemen. Queen Arwa University Journal, 30(30), 9. https://doi.org/10.58963/qausrj.v30i30.329

Plaudit

Similar Articles

11-20 of 127

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)