Extended HD and Nutrition
An attempt to do a metaanalysis of the literature on the impact of daily and nocturnal HD (15+ hours per week) on nutritional status failed due to lack of sufficient high quality papers. In five studies of nocturnal and/or daily HD—three in-center and two at home—lean body mass improved significantly and one study found deficiency in water-soluble vitamins.
Read the abstract » | (added 2022-11-16)
Must PD Stop when Residual Kidney Function is Gone?
Not necessarily. In a small, physiological study (n=15) of anuric CAPD patients with low Kt/V, fluid status, dietary intake, and nitrogen removal were all assessed. All were able to maintain good nutritional status, with no symptoms of nitrogen retention and good volume control.
Read the abstract » | (added 2022-02-14)
Oral Hygiene and Nutritional Status on PD
Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.
Read the abstract » | (added 2021-12-16)
A Better Nutritional Marker for CAPD Adequacy
Move over prealbumin, albumin, and ferritin—normalized protein catabolic rate (nPCR) was the only marker that correlated with CAPD adequacy in a study of 266 patients divided into an adequate (total weekly Kt/V urea >1.70) and an inadequate PD group (<1.70). Male gender, higher weight, and residual GFR <2.43 mL/min/1.73m2 were risk factors for inadequate CAPD.
Read the abstract » | (added 2021-02-09)
PD and Bone Mineral Disorders vs. HD
Body composition, nutritional status, DEXA, and bone mineral disease (BMD) biomarkers were assessed at baseline and one year in 242 ESRD patients starting either PD (n=138) or HD (n=104). Among HD patients, BMD decreased significantly—but not in PD patients. Preservation of BMD was associated with significantly lower all-cause mortality, with cortical bone preservation more predictive than trabecular bone preservation.
Read the abstract » | (added 2020-09-11)
Effect of a Nurse-led Program on PD Nutritional Status
In a controlled trial, 203 PD patients were randomly assigned to a study or control group. The study group received health education, treatments, case management, and nurse-led surveillance based on the Omaha system. The control group received usual care. After intervention, the study group had significantly more well-nourished patients (6.19% to 29.9%), and several other parameters were significantly improved as well. Hemoglobin, albumin, and pre-albumin were also significantly higher in the study group.
Read the abstract » | (added 2020-04-13)
Nocturnal HD Improves Nutritional Status
A metaanalysis was conducted of 9 studies with 229 patients who switched from standard to nocturnal HD. Those on nocturnal HD had significantly higher levels of serum albumin and protein and energy intake.
Read the abstract » | (added 2016-07-12)
How much dialysis improves nutritional status?
Is short daily HD enough dialysis to appetite, food intake, and improve serum albumin levels? Maybe after a long time on dialysis, says a new study. But those who did nocturnal HD needed fewer binders.
Read the abstract » | (added 2013-05-24)
More HD lowers C-reactive protein and boosts nutritional status
A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.
Read the abstract » | (added 2013-04-29)
Switching from standard to nocturnal HD has many benefits
We bet you won't be surprised to learn that the 13 patients studied had much lower BP (with fewer drugs), higher hemoglobins (with fewer ESAs), better nutritional status, and lower calcium-phosphorus product. (PTH rose in some, though.)
Read the abstract » | (added 2011-02-24)