WASHINGTON — Data presented here from the Dialysis Outcomes Practice Patterns Study indicated that patients who ate during their in-center hemodialysis treatments had higher serum albumin, higher potassium and lower phosphorus levels compared to patients who dialyzed at other clinics and did not eat during treatments.
“Providing nutrition during [hemodialysis] HD treatment may improve nutritional status and outcomes, but remains controversial,” Brandon Kistler, MD, of Ball State University, along with colleagues and additional researchers from the University of Irvine School of Medicine, wrote. “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.”
Using phase 5 of the Dialysis Outcomes and Practice Patterns Study, Kistler and colleagues looked at the relationship between baseline serum levels of albumin, phosphorus, potassium and BMI and compared outcomes to clinic policies related to eating during hemodialysis treatment. Such policies included the following:
- eating not allowed during treatment;
- patients may eat food provided by the clinic;
- patients may bring food from home; or
- patients may eat food provided by clinic and/or bring food from home.
Researchers only looked at countries with clinics utilizing all four policies on eating during hemodialysis. Results showed that, among 5,358 patients on hemodialysis (61% were men, age 66 ± 15 years, time on dialysis 4 ±6 years), “serum albumin and potassium were highest and phosphorus the lowest in patients dialyzing at clinics that provided food during HD (P < .05),” the authors wrote. “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 3.4 g/dl was higher in those dialyzing at clinics where food was provided by the clinic ... and those with food provided by the clinic and also allowed to bring their own food ... ”
“These [results] were expected, but this is the first study that corroborates and confirms the hypothesis, especially on better serum albumin,” Kamyar Kalantar-Zadeh, MD, of the University of California Irvine School of Medicine, and a co-author on the study, told Healio Nephrology. “Sadly, dialysis units in the U.S. do not provide food, and indeed in some of these units food during dialysis is prohibited.”
The authors wrote that further study is needed to determine if factors such as quality of life, hospitalizations, and mortality were impacted by eating during dialysis. –by Mark E. Neumann
Kistler B, et al. Abstract TH-PO598. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.