Background: This study observes the Healthy Eating Index (HEI) and Nutritional Status (NS) in hemodialysis patients treated at a private clinic in Cajamarca, Peru. Methods: Study type: descriptive, observational with exploratory component. The HEI was assessed using a food frequency questionnaire and a 24-hour dietary recall, alongside patient data, and a socioeconomic Status assessment. The NS was assessed using the Bilbrey Scale, Anthropometric Indices, and Bio-chemical Parameters. The study was approved by the Ethics Committee of the Cajamarca Regional Government. Results: This study found that 96.9% had an unhealthy eating index and 50.0% had a nutritional status of mild malnutrition. A total of 62.5% were adults; 68.8% were men; 75.0% had primary causes of diabetes mellitus type 2 and hypertension; 37.5% had a normal BMI; 100% had normal transferrin levels; and most consumed legumes and vegetables once or twice a week.
Conclusion: The population studied exhibited several co-morbidities alongside poor adherence to the Healthy Eating Index. However, there was no significant difference in HEI scores between those with and without moderate-to-severe malnutrition (p > 0.05). Unexpectedly, higher protein intake (in g/kg/day) was associated with a greater incidence of malnutrition (p = 0.001). The exploratory finding highlights the need for further research and may help refine dietary guidance to improve quality of life in this population.