Assessment of Dominant Dietary Patterns in Hemodialysis Patients Using Factor Analysis Method and Their Relationship With Anthropometric Indices and Metabolic Parameters: An Analytical Cross-Sectional Study

Chronic kidney disease (CKD) often progresses to end-stage renal disease (ESRD), requiring interventions like dialysis. Nutrition plays a key role in CKD management by affecting metabolic and anthropometric outcomes. This study assessed dominant dietary patterns in hemodialysis patients using factor analysis and their relationships with anthropometric and metabolic parameters. This cross-sectional study included 300 adult hemodialysis patients selected through systematic sampling from dialysis centers in Ahvaz, Iran. Dietary intake was evaluated using a validated 168-item Food Frequency Questionnaire (FFQ). Principal Component Analysis (PCA) identified 3 dietary patterns: Western, Mixed, and Traditional. Anthropometric indices (BMI, waist circumference) and metabolic parameters (lipid profiles, renal markers) were assessed. Multiple linear regression adjusted for confounders was applied. The Western Pattern was positively associated with higher BMI (+1.41 kg/m 2 , P < .001), WC (+3.67 cm, P < .001), total cholesterol (+11.81 mg/dL, P < .001), and LDL-C (+9.54 mg/dL, P < .001). The Mixed Pattern showed protective effects, reducing WC (−3.30 cm, P < .001), TC (−6.13 mg/dL, P = .004), LDL-C (−5.01 mg/dL, P = .001), and uric acid (−0.75 mg/dL, P = .03). The Traditional Pattern was linked to lower BMI (−1.57 kg/m 2 , P < .001), WC (−3.91 cm, P < .001), improved HDL-C (+1.73 mg/dL, P = .02), and reduced systolic blood pressure (−3.57 mmHg, P < .001). Dietary patterns significantly impact metabolic and anthropometric health in hemodialysis patients. Adopting culturally relevant dietary patterns like the Traditional Pattern may improve outcomes. Further longitudinal studies are warranted.