Short daily hemodialysis rapidly improves nutritional status in hemodialysis patients.
BACKGROUND
Malnutrition is a common problem in maintenance hemodialysis patients and is associated with increased mortality and morbidity. Interventions such as oral or intravenous nutritional supplements have often failed to improve nutritional status. We studied the effect of a daily dialysis program on nutritional parameters.


METHODS
Eight patients treated with standard hemodialysis (SHD) 4 to 5 hours three times per week were converted to daily hemodialysis (DHD) 2 to 2.5 hours six times per week. Serum albumin, prealbumin, and total cholesterol were evaluated every three months. Anthropometry and dietary evaluation were performed every six months.


RESULTS
Serum albumin rose from 39.0 +/- 2.6 to 42.0 +/- 3.1 and 43.0 +/- 2.6 g/L, prealbumin from 0.36 +/- 0.04 to 0.41 +/- 0.05 and 0.42 +/- 0.1 g/L, total cholesterol from 1.7 +/- 0.4 to 1.9 +/- 0.4 and 1.8 +/-0.3 g/L at baseline and at 6 and 12 months, respectively, after switching patients to DHD. Daily protein intake increased from 1.29 +/- 0.20 g/kg/day to 1.48 +/- 0.60 and 1.90 +/- 0.70 (P < 0.05). These changes were accompanied by a dry body weight increase of 2.4 +/- 1.6 kg (P < 0.005) at month 6 and 4.2 +/- 2.8 kg at one year (P < 0.05). Lean body mass increased from 47.7 +/- 4.9 kg to 49.1 +/- 5.9 (P < 0.05) and 50.5 +/- 6.2 (P < 0.05).


CONCLUSIONS
Daily hemodialysis appears to be a suitable method to improve nutritional status in maintenance dialysis patients.
Galland
R
R
Association pour l'utilisation du Rein Artificiel, and Département de Néphrologie, Hôpital Edouard Herriot, Lyon, France. galland@auralyon.com
Traeger
J
J
Arkouche
W
W
Cleaud
C
C
Delawari
E
E
Fouque
D
D
D000328:Adult; D001823:Body Composition; D001835:Body Weight; D002319:Cardiovascular System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000379:methods*; D013851:Thinness; D013997:Time Factors