Hamdan Zakaria, Nazzal Zaher, Zidan Souzan, Bsharat Lawra, Ishtayah Sanaa, Sammoudi Sarah, Badrasawi Manal
Department of Internal Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
BMC Nutr. 2025 May 13;11(1):95. doi: 10.1186/s40795-025-01081-7.
Hemodialysis affects patients' nutritional status in several ways, resulting in malnutrition, which, in turn, increases the rates of morbidity and mortality worldwide. The main aim of this study was to comprehensively examine the effect of sex-based differences on the nutritional status of Palestinian patients on hemodialysis.
This study involved hemodialysis patients from An-Najah National University Hospital (NNUH) at Nablus/Palestine. A structured questionnaire was used in this study to collect data about sociodemographic data, medical history, lifestyle habits, and functional status, as well as nutritional status, which was assessed using 4 components (anthropometric measurements, biochemical data, clinical data, and dietary data). Patients' reports were reviewed to obtain laboratory values. The malnutrition-inflammation score was used to assess the prevalence of malnutrition. Data were analyzed using univariate and multivariate analysis.
A total of 188 hemodialysis patients participated in the study. The mean age was 57.8 ± 14.0 years, ranging from 19 to 86 years old. Females were more likely to experience nausea and headache during hemodialysis than men (p < 0.05). The findings also showed that the MIS score was significantly higher in women than in men. Biochemical findings revealed that female patients had significantly lower levels of blood urea nitrogen (p = 0.003), carbon dioxide (p = 0.020), ferritin levels (p = 0.025), and serum phosphate levels (p = 0.000). In addition, women had significantly lower intakes of total carbohydrate, total fat, saturated fat, monounsaturated fatty acids, water, vitamin B1, vitamin B2, vitamin B3, calcium, phosphate, sodium, and zinc, except for vitamin B12, which was higher in females. Furthermore, functional assessments indicated that males have significantly higher handgrip strength than females, while females represented more severe malnutrition compared to males.
Our data indicates that women have more severe malnutrition compared to men, suggesting the need to consider sex-based nutritional and functional differences in hemodialysis patients by healthcare professionals.
血液透析通过多种方式影响患者的营养状况，导致营养不良，而营养不良又反过来增加了全球范围内的发病率和死亡率。本研究的主要目的是全面考察性别差异对巴勒斯坦血液透析患者营养状况的影响。
本研究纳入了来自巴勒斯坦纳布卢斯安纳贾国立大学医院（NNUH）的血液透析患者。本研究使用结构化问卷收集社会人口统计学数据、病史、生活方式习惯、功能状态以及营养状况等方面的数据，营养状况通过四个方面进行评估（人体测量、生化数据、临床数据和饮食数据）。查阅患者报告以获取实验室值。使用营养不良 - 炎症评分来评估营养不良的患病率。数据采用单因素和多因素分析。
共有188名血液透析患者参与了本研究。平均年龄为57.8±14.0岁，年龄范围为19至86岁。女性在血液透析期间比男性更容易出现恶心和头痛（p<0.05）。研究结果还表明，女性的营养不良 - 炎症评分显著高于男性。生化检查结果显示，女性患者的血尿素氮水平（p = 0.003）、二氧化碳水平（p = 0.020）、铁蛋白水平（p = 0.025）和血清磷酸盐水平（p = 0.000）显著较低。此外，女性的总碳水化合物、总脂肪、饱和脂肪、单不饱和脂肪酸摄入量、水、维生素B1、维生素B2、维生素B3、钙、磷酸盐、钠和锌的摄入量均显著较低，但维生素B12除外，女性的维生素B12摄入量较高。此外，功能评估表明，男性的握力显著高于女性，而女性与男性相比存在更严重的营养不良。
我们的数据表明，女性比男性存在更严重的营养不良，这表明医疗保健专业人员有必要考虑血液透析患者基于性别的营养和功能差异。
