Interpersonal Psychosocial Factors Associated With Underreported Dietary Energy Intake in Hemodialysis Patients

Objective: To examine the association between degree of underreporting energy intake and psychosocial (including interpersonal and personal) factors among hemodialysis patients in Japan. Design: We conducted a cross-sectional study. Predictors of difference were identified using multiple linear regression analysis. Setting: Study was conducted at a public hospital and a dialysis clinic in a single district in northeast Honshu, Japan. Subjects: Participants were hemodialysis outpatients. Patients aged more than 20 years and undergoing treatment for end-stage renal disease for at least 6 months were included. Exclusion criteria were diagnosis of depression, a mental disease, or dementia. Main Outcome: The outcome measure was the difference in reported energy intake defined by the differences between a brief administered dietary history questionnaire and diet record stratified by standardized weight. Results: Seventy patients undergoing hemodialysis participated (44 men [62.9%] and 26 women [37.1%]). Of these, 54.3% underreported energy intake (by >10%). Sex (male) and employment status (employed) were statistically associated with energy intake underreporting. A lower score of dialysis staff encouragement was associated with greater energy intake underreporting (β coefficient = 3.89 kcal/standardized weight, 95% confidence interval: 0.89 to 6.90; P = .012). Conclusion: Degree of underreporting energy intake is significantly associated with interpersonal psychosocial factors among hemodialysis patients in Japan. The interpersonal relationship with encouragement by the dialysis staff is important in improving the accuracy of reporting energy intake among dialysis patients.