Nursing Care of Malnourished Hemodialysis Patients: A Case Study


  • Chiraphorn Phrakhunanan Faculty of Nursing, Kaserm Bundit University
  • Sasipim Pairojkittrakul Registered Nurse, Senior Professional Level, Thammasat University Hospital
  • Surasit Chouyboon Faculty of Nursing, Kaserm Bundit University


End stage renal disease, Hemodialysis, Malnutrition


Chronic kidney disease (CKD) involves permanent abnormalities for kidney structure or function. Disease severity is progressive to stage V, known as end-stage kidney disease, at which point patients should receive renal replacement therapy. Hemodialysis is a high quality renal replacement therapy and very popular in Thailand. However, hemodialysis can result in a catabolic state and loss of amino acids during dialysis. Furthermore, the patient may experience uremia symptoms that cause anorexia, nausea, and vomiting. Thus, hemodialysis patients are more likely to develop malnutrition. The purpose of this article is to present a case study on nursing care for malnourished hemodialysis patients, involving a patient who had been on hemodialysis for seven years and was malnourished. However, the patient refused a feeding tube. The patients’ nutritional status was determined by dietary assessment, clinical assessment, and a nutrition assessment tool. This information was collected to determine the related nursing diagnosis followed by modifications to the nursing care plan and provision of nursing care. In addition, an evaluation of nursing care and patient responses were continuously analyzed.


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How to Cite

Phrakhunanan, C., Pairojkittrakul, S., & Chouyboon, S. (2024). Nursing Care of Malnourished Hemodialysis Patients: A Case Study. Nursing Journal CMU, 51(1), 284–296. Retrieved from



Academic Article