title: The effect of frequent hemodialysis on nutrition and body composition: frequent Hemodialysis Network Trial.
abstract: We investigated the effects of frequency of hemodialysis on nutritional status by analyzing the data in the Frequent Hemodialysis Network Trial. We compared changes in albumin, body weight, and composition among 245 patients randomized to six or three times per week in-center hemodialysis (Daily Trial) and 87 patients randomized to six times per week nocturnal or three times per week conventional hemodialysis, performed largely at home (Nocturnal Trial). In the Daily Trial, there were no significant differences between groups in changes in serum albumin or the equilibrated protein catabolic rate by 12 months. There was a significant relative decrease in predialysis body weight of 1.5 ± 0.2 kg in the six times per week group at 1 month, but this significantly rebounded by 1.3 ± 0.5 kg over the remaining 11 months. Extracellular water (ECW) decreased in the six times per week compared with the three per week hemodialysis group. There were no significant between-group differences in phase angle, intracellular water, or body cell mass (BCM). In the Nocturnal Trial, there were no significant between-group differences in any study parameter. Any gain in 'dry' body weight corresponded to increased adiposity rather than muscle mass but was not statistically significant. Thus, frequent in-center hemodialysis reduced ECW but did not increase serum albumin or BCM while frequent nocturnal hemodialysis yielded no net effect on parameters of nutritional status or body composition.
authors.affiliation: Department of Medicine, Division of Nephrology, University of California, Davis School of Medicine, Davis, California 95616, USA. gakaysen@ucdavis.edu
authors.forename: George A
authors.initials: GA
authors.lastname: Kaysen
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: Brett
authors.initials: B
authors.lastname: Larive
authors.forename: Ravindra L
authors.initials: RL
authors.lastname: Mehta
authors.forename: Robert M
authors.initials: RM
authors.lastname: Lindsay
authors.forename: Tom A
authors.initials: TA
authors.lastname: Depner
authors.forename: Yoshio N
authors.initials: YN
authors.lastname: Hall
authors.forename: John T
authors.initials: JT
authors.lastname: Daugirdas
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001823:Body Composition; D001834:Body Water / Q000378:metabolism; D001835:Body Weight; D004044:Dietary Proteins / Q000378:metabolism; D017097:Electric Impedance; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012709:Serum Albumin / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D015415:Biomarkers; D004044:Dietary Proteins; D012709:Serum Albumin