Eating during the Hemodialysis Session: A Practice Improving Nutritional Status or a Risk Factor for Intradialytic Hypotension and Reduced Dialysis Adequacy?

Nutrients
Eleni FotiadouVassilios Liakopoulos

Abstract

Historically, eating during the hemodialysis treatment has been associated with increased risk for adverse intradialytic symptoms and events, risks that have resulted in the implementation of restrictive in-center nutrition policies. Recent studies, however, have recorded a shift in clinical practice with a higher proportion of physicians following the view that administration of intradialytic meals and supplements represents a simple and effective approach to enhance caloric intake and improve nutritional status among patients on hemodialysis. This shift towards less restrictive in-center nutrition practices is mainly supported by evidence from observational studies associating intradialytic nutritional supplementation with improvements in protein-energy wasting, inflammatory state, and health-related quality of life. In sharp contrast, earlier and recent interventional studies have documented that feeding during the hemodialysis treatment provokes a rapid postprandial decline in blood pressure and raises the incidence of symptomatic intradialytic hypotension. Furthermore, other studies have shown that postprandial redistribution in intravascular volume and enhanced blood supply to the gastrointestinal circulation may interfer...Continue Reading

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Citations

Dec 23, 2020·Nutrients·Vassilios Liakopoulos, Evangelia Dounousi
May 1, 2021·Nutrients·Hiroyuki TakashimaMasanori Abe
Jul 17, 2021·Néphrologie & thérapeutique·Maryvonne HourmantFrançois Vrtovsnik
Aug 31, 2021·Frontiers in Nutrition·Giacomo GaribottoGiuliano Brunori

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