Intradialytic Feeding Practice and Nutritional Status of Maintenance Hemodialysis Patients in Alexandria, Egypt

Abstract

Background: Malnutrition is a common complication of hemodialysis that needs to be prevented, properly diagnosed and treated. Intra-dialytic feeding is a controversial yet effective method to help improve nutritional status. Objective(s): To assess intradialytic dietary pattern and nutritional status of hemodialysis patients and determine the energy and protein adequacy on hemodialysis and non-hemodialysis days. Methods: A cross sectional study was conducted using a predesigned interview questionnaire, 3-day 24-hour diet recall, anthropometric measurements, serum albumin and total iron binding capacity measurements, and malnutrition inflammation score (MIS) for 150 hemodialysis patients. Results: More than three quarters of the patients reported eating during the hemodialysis session with 71.3% of them eating due to the long session hours. Mean energy and protein intake on hemodialysis days was 1743.0 ± 718.1 kcal and 73.78 ± 37.15 g, respectively, which was significantly higher among patients who eat than those who don’t eat during the hemodialysis session (p < 0.001). Although mean serum albumin was higher in patients who eat during dialysis session and MIS was lower, there was no statistically significant difference between both groups. Conclusion: Intradialytic feeding is a common practice in chronic hemodialysis patients. Both energy and protein intakes and their adequacies were found to be higher in patients who eat during the dialysis session. This hints at the importance of utilization of dialysis session time to enhance the patients’ nutritional status. Therefore, it is recommended to individualize the advice of intradialytic feeding according to the patient’s needs.

Keywords

• end stage renal disease
• hemodialysis
• malnutrition
• intradialytic feeding
• energy adequacy
• protein adequacy
• malnutrition inflammation score