Factors affecting appetite and correlation with quality of life of patients undergoing hemodialysis.

Abstract

Introduction: Chronic kidney disease, which usually is treated with the method of hemodialysis, affects patients’
appetite for food. An important indicator of the effectiveness of treatment is the quality of life of patients with chronic
kidney disease undergoing dialysis. Aim: The purpose of this study is to investigate the factors affecting appetite and
their association with the quality of life in patients undergoing hemodialysis. Material and Method: This is a systematic
review. Articles were searched in the PubMed, Scopus, and Cinahl databases with the following keywords: This is a
systematic review. Articles were searched in the PubMed, Scopus, and Cinahl databases with the following keywords:
“appetite, quality of life, hemodialysis, malnutrition” published from 2011-2020. Inclusion criteria were: their content
should be relevant to the study and be written in English. Articles that were secondary studies, such as reviews, metaanalyzes, case studies, and those written in a language other than English, were excluded from the study. The PRISMA
method was applied, and, after the final evaluation of the studies, 11 articles were included in the systematic review.
Results: Three studies focused on reduced appetite, four on malnutrition, and four on the relationship between the
factors of reduced appetite and quality of life. Six studies were cross-sectional, one prospective study, one cross-sectional
with intervention and control group, one retrospective cohort analysis, one cross-sectional with hemodialysis and
peritoneal dialysis patients, and one analytic descriptive with intervention and control group. Conclusions: Alteration
of taste receptors, reduced hypothalamic hormone production, chronic inflammation, and deregulation of the endocannabinoid
system are factors of decreased appetite in patients undergoing hemodialysis. Anorexia is exacerbated by factors such as old
age, depression, and socioeconomic difficulties. Decreased appetite and the interaction of poor nutritional status with
depression negatively affect patients’ quality of life, with consequences for physical, mental health, social life, and sleep
quality. The aim should be the continuous evaluation and improvement of the appetite and the nutritional status of
these patients, in order to achieve the maximum level of quality of life.