Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012-2015)

Nutrition is an important factor in maintaining good health of hemodialysis (HD) patients, affecting their morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international observational study assessing differences in dialysis practices and outcomes across > 20 countries. Here, we present the results for the Gulf Cooperation Council (GCC) countries regarding nutrition data and its relationship with outcomes as a part of the DOPPS Phase 5 study (2012-2015). Data were from Phase 5 of the DOPPS. Main analyses were based on 927 adult chronic HD patients enrolled at the start of the GCC-DOPPS Phase 5 study from each of the 40 randomly selected GCC HD facilities from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Within each participating facility, 20-30 patients were randomly selected, depending on facility size. Analysis showed minor differences across GCC countries in age, albumin levels, nutrition supplement use, and being bothered by the lack of appetite. Elderly (> 60 years old) and diabetic HD patients displayed poorer nutritional parameters than young and nondiabetic patients. A low albumin level (< 3.2 g/dL) was associated with the highest risk of mortality with a hazard ratio (HR) of 2.47 (P < 0.0001) followed by diabetes with HR 1.57 (P < 0.04) and older age [HR= 1.27/10 years older (P < 0.01)]. Quality of life measures physical component summary and mental component summary correlated negatively with albumin < 3.2 g/dL (2.18 and 5.5, respectively, P < 0.05 for each), and with serum creatinine level < 7.5 mg/dL (2.29 and 2.1 respectively, P < 0.05 for each. We are presenting the first study of the nutrition status and outcomes for HD patients in the GCC countries in DOPPS. Our results were mostly comparable to findings in previous trials in other countries. Although the data are observational, our study provides good insight into aspects of nutrition in the GCC countries and can be compared to the rest of the world to better understand trends and practice differences.