Effect of nocturnal haemodialysis on body composition.
BACKGROUND
Haemodialysis patients have a high risk of malnutrition which is associated with increased mortality. Nocturnal haemodialysis (NHD) is associated with a significant increase in protein intake compared with conventional haemodialysis (CHD). It is unclear whether this leads to improved nutritional status. Therefore, we studied whether 1 year of NHD is associated with a change in body composition.


METHODS
Whole-body composition using dual-energy X-ray absorptiometry (DEXA) and normalised protein catabolic rate (nPCR) were measured in 11 adult patients before and 1 year after the transition from CHD (12 h dialysis/week) to NHD (28-48 h dialysis/week). Similar measurements were performed in a matched control group of 13 patients who stayed on CHD. Differences between groups were analysed with linear mixed models.


RESULTS
At baseline, nPCR, total mass, fat-free mass, and fat mass did not differ significantly between the CHD and NHD groups. nPCR increased in the NHD group (from 0.96 ± 0.23 to 1.12 ± 0.20 g/kg/day; p = 0.027) whereas it was stable in the CHD group (0.93 ± 0.21 at baseline and 0.87 ± 0.09 g/kg/day at 1 year, n.s.). The change in nPCR differed significantly between the two groups (p = 0.027). We observed no significant differences in the course of total mass, fat-free mass, and fat mass during the 1-year observation period between the NHD and CHD groups.


CONCLUSIONS
One year of NHD had no significant effect on body composition in comparison with CHD, despite a significantly higher protein intake in patients on NHD.
Dialysis Center Groningen, Groningen, The Netherlands.
Karin J R
KJ
Ipema
Ralf
R
Westerhuis
Cees P
CP
van der Schans
Paul E
PE
de Jong
Carlo A J M
CA
Gaillard
Wim P
WP
Krijnen
Riemer H J A
RH
Slart
Casper F M
CF
Franssen
D000328:Adult; D000368:Aged; D001823:Body Composition; D005260:Female; D006437:Hemodialysis, Home; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies