The Effect of Nocturnal and Conventional Hemodialysis on Markers of Nutritional Status: Results From a Randomized Trial
published online 22 July 2010. Corrected Proof
Objective
More frequent dialysis may improve nutrition and remove dietary restrictions in hemodialysis (HD) patients. We present results from a trial comparing nutritional parameters between nocturnal hemodialysis (NHD) and conventional HD patients.
Methods
Patients were randomized to conventional thrice weekly HD or NHD for a 6-month study period. Dietary intake was recorded by patients using a 3-day food record at baseline and study exit.
Results
Of 51 patients, 23 completed baseline and exit food records and were included in the analysis. Although dietary intake of calcium, potassium, and lipids increased in the NHD group, serum levels of calcium and potassium remained within target limits. The majority of NHD subjects were able to reduce or discontinue their phosphate binders and maintain serum phosphate levels within target limits. Serum albumin improved among the NHD group (0.7 g/L) and declined for the conventional group (−1.6 g/L). None of the between group differences achieved statistical significance.
Conclusions
As compared with conventional dialysis, NHD was associated with a nonstatistically significant increase in dietary intake for some nutrients, with maintenance of serum levels for potassium, calcium, and phosphorus. Whether increased dietary intake translates into improvement in morbidity and mortality remains to be determined.
∗Department of Medicine, University of Calgary, Alberta, Canada
†Department of Community Health Sciences, University of Calgary, Alberta, Canada
‡Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
§Department of Critical Care, University of Alberta, Edmonton, Alberta, Canada
¶Alberta Health Services, Calgary, Alberta, Canada
Address reprints requests to Brenda R. Hemmelgarn, MD, PhD, Division of Nephrology, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9.
This research was supported by a grant from the Kidney Foundation of Canada. Drs Manns, Tonelli and Hemmelgarn are supported by New Investigator Awards from the Canadian Institute of Health Research and Drs Klarenbach, Tonelli and Hemmelgarn are supported by Population Health Investigator Awards from the Alberta Heritage Foundation for Medical Research. Dr Walsh is supported by the Kidney Research Scientist Core Education Training Program and the Alberta Heritage Foundation for Medical Research. Ms Barnieh is supported by an Allied Health Fellowship Award from the Kidney Foundation of Canada.
This manuscript has been seen and approved by all authors and is not under consideration for publication elsewhere except in abstract form. This randomized controlled trial involved investigation of human subjects and was approved by the ethics committee of the University of Calgary.
ABSTRACT