{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:13:25Z","timestamp":1793333605487,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005712","name":"University of Jordan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005712","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,17]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The primary aim of this study is to evaluate protein\u2013energy wasting in haemodialysis patients and assess their adherence to renal-specific guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients were recruited from four major governmental hospitals in Amman, Jordan; The University of Jordan Hospital; Al-Hussain Medical Center, Al-Basheer Hospital; and Prince Hamzah Hospital. Data were collected during the period between January 2022 and January 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The sample consisted of 344 adult patients who were above the age of 18 years with end-stage renal disease and undergoing haemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Anthropodermic measurements were performed, and biochemical and dietary data were collected during dialysis sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The occurrence of protein\u2013energy wasting, as indicated by a low albumin level (&lt;40\u2009g\/L), was 59.6%. The intakes of most of the nutrients were significantly lower than the recommended corresponding values except for fat, where average consumption was significantly higher than the recommended dietary intakes (33.8%, p value=0.000). Mean protein and calorie intakes were associated with serum albumin levels (p value=0.003\u2009and 0.044, respectively). 70% of the study participants revealed that they have rarely or never been spoken to regarding the importance of a renal-specific diet by their healthcare provider. Among study participants, 24% faced a great level of difficulty in following dietary recommendations, and approximately 15% indicated their inability to follow any recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dietary intake was not adequate according to the dietary guidelines for haemodialysis patients, which could contribute to their low albumin levels and augment the risk of protein\u2013energy wasting. Haemodialysis patients may experience defective nutritional care and a reduced level of commitment to dietary recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094530","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T19:05:34Z","timestamp":1741115134000},"page":"e094530","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Protein\u2013energy wasting risk in end-stage renal disease patients undergoing haemodialysis and patients\u2019 adherence to dietary recommendations in Jordan: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"given":"Dima","family":"Farrah","sequence":"first","affiliation":[{"name":"Department of Nutrition and Food Technology, The University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7877-1011","authenticated-orcid":false,"given":"Shatha Sabri","family":"Hammad","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, The University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Awwad","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, The University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shatha Abu","family":"Alnadi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, The University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Al-Btoush","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, The University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"2025120600422739000_15.3.e094530.1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.5812\/numonthly.1825","article-title":"End-Stage Renal Disease and Renal Replacement Therapy in older Patients","volume":"4","author":"Smyth","year":"2012","journal-title":"Nephrourol Mon"},{"key":"2025120600422739000_15.3.e094530.2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1053\/j.jrn.2014.08.006","article-title":"Understanding the associations between modifying factors, individual health beliefs, and hemodialysis patients\u2019 adherence to a low-phosphorus diet","volume":"25","author":"Elliott","year":"2015","journal-title":"J Ren Nutr"},{"key":"2025120600422739000_15.3.e094530.3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.21767\/2471-299X.1000038","article-title":"Contributing Factors to Non-Adherence among Chronic Kidney Disease (CKD) Patients: A Systematic Review of Literature","volume":"02","author":"Chironda","year":"2016","journal-title":"Abdelkader Boukerrouche"},{"key":"2025120600422739000_15.3.e094530.4","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.cegh.2018.05.003","article-title":"Adherence to dietary and fluid restrictions among patients undergoing hemodialysis: An observational study","volume":"7","author":"Beerappa","year":"2019","journal-title":"Clin Epidemiol Glob Health"},{"key":"2025120600422739000_15.3.e094530.5","doi-asserted-by":"crossref","first-page":"971","DOI":"10.11124\/JBISRIR-2017-003360","article-title":"Effectiveness of educational or behavioral interventions on adherence to phosphate control in adults receiving hemodialysis: a systematic review","volume":"15","author":"Milazi","year":"2017","journal-title":"JBI Database System Rev Implement Rep"},{"key":"2025120600422739000_15.3.e094530.6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/jjns.12055","article-title":"Adherence to diet and fluid restriction of individuals on hemodialysis treatment and affecting factors in Turkey","volume":"12","author":"Efe","year":"2015","journal-title":"Jpn J Nurs Sci"},{"key":"2025120600422739000_15.3.e094530.7","doi-asserted-by":"crossref","DOI":"10.34172\/jrip.2020.15","article-title":"The prevalence of malnutrition in hemodialysis patients","volume":"9","author":"Ghorbani","year":"2020","journal-title":"J Renal Inj Prev"},{"key":"2025120600422739000_15.3.e094530.8","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1053\/j.jrn.2018.08.006","article-title":"Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism","volume":"28","author":"Carrero","year":"2018","journal-title":"J Ren Nutr"},{"key":"2025120600422739000_15.3.e094530.9","unstructured":"MOH . 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