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Abstract: TH-PO598

The Impact of Eating During Hemodialysis Treatment on Nutritional Measures in In-Center Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Kistler, Brandon, Ball State University, Muncie, Indiana, United States
  • Ritter, Mickala, Ball State University, Muncie, Indiana, United States
  • Khubchandani, Jagdish, Ball State University, Muncie, Indiana, United States
  • Rhee, Connie, University of California Irvine, Huntington Beach, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
Background

Poor nutritional status is common among patients receiving hemodialysis (HD) treatment. Providing nutrition during HD treatment may improve nutritional status and outcomes, but remains controversial. This has led to the adoption of different in-center dialysis unit nutrition policies. Therefore, we sought to examine the relationship between policies on food intake during treatment and nutrition-related measures.

Methods

We analyzed data from Phase 5 of the Dialysis Outcomes and Practice Patterns Study (DOPPS) to look at the relationship between baseline nutrition-related measures (serum levels of albumin, phosphorus, potassium, and body mass index (BMI)) and clinic policy related to eating during HD (not allowed, patients may eat food provided by clinic, patients may bring food from home, or patients may eat food provided by clinic and/or brought from home). We limited our analysis to only countries with clinics utilizing all four policies on eating during HD. Nutritional measures were compared by ANCOVA with individual differences determined by least square difference post-hoc. Additionally, the odds of having an albumin >3.4 g/dl were determined by multivariable logistic regression.

Results

Among 5,358 HD patients (61% male, age 66±15 years, vintage 4±6 years) included in the analysis, serum albumin and potassium were highest and phosphorus the lowest in patients dialyzing at clinics that provided food during HD (p<0.05). Body mass index (BMI) was highest among patients dialyzing at clinics that allowed patients to bring their own food. Compared to patients who dialyzed at clinics where they were not allowed to eat, the odds of having an albumin above 3.4g/dl was higher in those dialyzing at clinics where food was provided by the clinic (Adjusted OR=2.0, 95% CI 1.6-2.6) and those with food provided by the clinic and also allowed to bring their own food (Adjusted OR=1.6, 95% CI 1.3 – 2.0).

Conclusion

Patients who dialyze at clinics that provide food during HD treatment exhibit higher serum albumin, higher potassium, and lower phosphorus levels than patients who dialyzed at other clinics. Whether in-center nutrition and eating policies contribute to differences in other clinical outcomes including quality of life, hospitalizations, and mortality warrants additional studies.