title: A difference between day and night: protein intake improves after the transition from conventional to frequent nocturnal home hemodialysis.
abstract: BACKGROUND
  Malnutrition is an important cause of the excessive morbidity and mortality rate of dialysis patients. Frequent nocturnal home hemodialysis (NHHD) has many benefits compared with conventional thrice-weekly hemodialysis (CHD), due to the virtual absence of dietary restrictions and a much higher overall dialysis efficiency. In this observational study, we investigated whether these benefits of NHHD translate into an improved nutritional intake, with a special emphasis on protein intake.
  
  
  METHODS
  We prospectively assessed the effect of the transition of CHD to NHHD on nutritional intake (5-day dietary intake journal), normalized protein catabolic rate, and anthropometric parameters in 15 consecutive patients who started NHHD in our center between 2004 and 2009 and completed at least 8 months of follow-up. Data were collected before the transition from CHD to NHHD and 4 and 8 months after the transition.
  
  
  RESULTS
  Protein intake, as measured by both dietary intake journal and normalized protein catabolic rate, increased significantly after the transition from CHD to NHHD. Accordingly, phosphate intake increased significantly; however, serum phosphate levels did not increase, despite negligible phosphate binder use during NHHD. Body mass index and upper arm muscle circumference did not change significantly.
  
  
  CONCLUSIONS
  The transition from CHD to NHHD has a positive effect on nutritional intake, in particular, protein intake. NHHD should be considered in malnourished patients on CHD.
authors: Dialysis Center Groningen, Groningen, The Netherlands.
authors: Karin J R
authors: KJ
authors: Ipema
authors: Cees P
authors: CP
authors: van der Schans
authors: Noortje
authors: N
authors: Vonk
authors: Jorien M
authors: JM
authors: de Vries
authors: Ralf
authors: R
authors: Westerhuis
authors: Ellen
authors: E
authors: Duym
authors: Casper F M
authors: CF
authors: Franssen
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000097:blood; D004046:Dietetics; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006437:Hemodialysis, Home / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000503:physiopathology; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D004044:Dietary Proteins; D010710:Phosphates