Association between dialysis dose improvement and nutritional status among hemodialysis patients

BACKGROUND: Several studies suggest an association between improved survival and better nutritional status. It has been suggested that there is a correlation between dose of dialysis and nutritional status. However, in spite of the current practice, there are conflicting reports regarding the relationship between dose of dialysis or malnutrition, and biochemical outcome. In this article, we will discuss the impact of dose of dialysis on nutritional status and biochemical outcome in hemodialysis patients. We will also mention the interrelationships of dialysis dose, malnutrition, and biochemical outcome with respect to these patients.

METHODS: Data were processed on 134 dialysis patients (mean age 48.21 +/- 13.38, 69 male, 65 female) on 3-times-per-week dialysis regimens. The overall study period was 3 months from June 1, 2005 to August 31, 2005. The patients were divided into two groups: the baseline group and the intervention group. The data of the baseline group were collected in June, 2005 and the data of the intervention group were collected in August, 2005 after applying the intervention or a protocol for dialysis adequacy improvement.

RESULTS: The statistical analysis demonstrated that there was a significant improvement in mean URR and Kt/V from the baseline to the intervention group. The intervention group had a considerably higher rate than the baseline group for all nutritional and biochemical outcome parameters. The study showed a strong positive correlation between nPCR and Kt/V (p = 0.0001) and also a strong positive correlation between serum albumin and Kt/V (p = 0.00001). No correlations were found between Kt/V and biochemical outcomes such as hemoglobin (p = 0.4922), calcium (p = 0.650), phosphate (p = 0.508), and phosphatase (p = 0.091).

CONCLUSION: All the available evidence in hemodialysis patients confirms the close association between dialysis dose and biochemical outcome. A body of evidence also highlights the existence of relationship between malnutrition and outcome among these patients. Dose of dialysis and nutrition are considered to be interrelated.