The effect of nocturnal and conventional hemodialysis on markers of nutritional status: results from a randomized trial.
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.
Schorr
Melissa
M
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Manns
Braden J
BJ
Culleton
Bruce
B
Walsh
Michael
M
Klarenbach
Scott
S
Tonelli
Marcello
M
Sauve
Lia
L
Chin
Rick
R
Barnieh
Lianne
L
Hemmelgarn
Brenda R
BR
D000328:Adult; D000368:Aged; D015415:Biomarkers; D002118:Calcium / Q000097:blood*; D004435:Eating; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010710:Phosphates / Q000097:blood*; D011188:Potassium / Q000097:blood*; D006435:Renal Dialysis / Q000379:methods*; D012709:Serum Albumin / Q000032:analysis
D015415:Biomarkers; D010710:Phosphates; D012709:Serum Albumin; D011188:Potassium; D002118:Calcium