Latent profiles of nutrition literacy among patients receiving peritoneal dialysis and their associations with dietary adherence and nutritional and metabolic indicators: a multicenter cross-sectional study

BackgroundNutrition literacy is important for dietary self-management among patients receiving peritoneal dialysis (PD), yet the heterogeneity of nutrition literacy and its associations with dietary adherence and nutritional and metabolic indicators remain poorly understood.AimsTo identify latent nutrition literacy profiles among patients receiving PD, examine factors associated with profile membership, and explore differences in dietary adherence and nutritional and metabolic indicators across profiles.MethodsA multicenter cross-sectional study was conducted among 307 patients receiving PD from three tertiary hospitals in Hainan Province, China, between May and December 2025. Data were collected using a demographic questionnaire, the Nutrition Literacy Scale for Patients with End-Stage Kidney Disease Undergoing Dialysis, and the Renal Adherence Attitudes Questionnaire and the Renal Adherence Behaviour Questionnaire. Nutritional and metabolic indicators were extracted from electronic medical records. Latent profile analysis was performed using Mplus 8.3, and group comparisons and multinomial logistic regression analyses were conducted using SPSS 27.0.ResultsThe mean nutrition literacy score was 14.10 ± 5.01. Three nutrition literacy profiles representing relatively low (46.5%), moderate (30.0%), and high (23.5%) levels were identified. Compared with the low profile, female sex and higher monthly personal income were associated with the moderate profile, while female sex, younger age, higher educational attainment, higher income, and longer dialysis duration were associated with the high profile (all p < 0.05). Differences across profiles remained statistically significant after false discovery rate correction for dietary adherence behavior and attitude scores and for several nutritional and metabolic indicators, including hemoglobin, serum albumin, lipid profiles, body mass index, and electrolyte levels (all adjusted p < 0.05).ConclusionNutrition literacy among patients receiving PD was heterogeneous, with three profiles differing in sociodemographic and disease-related characteristics, dietary adherence scores, and several nutritional and metabolic indicators. These profiles may provide a descriptive framework for recognizing subgroups with different nutrition support needs; however, their clinical utility requires external and longitudinal validation.