Effect Of Predialytic and Intradialytic Oral Nutritional Supplementation On Adequacy of Hemodialysis: A Quasi-experimental Analysis

Fahad Riaz; Abdul Rehman  Arshad; Zubair  Ahmed; Muhammad  Iqbal; Muhammad Zulqurnain  Saleem; Rabia  Parveen

doi:10.51253/pafmj.v76iSUPPL-6.11000

Authors

Fahad Riaz Department of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Abdul Rehman Arshad Department of Nephrology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Zubair Ahmed Department of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Iqbal Department of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Zulqurnain Saleem Department of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Rabia Parveen Department of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.11000

Keywords:

Hemodialysis, High Protein Diet, Nutritional Support, Protein Energy Malnutrition, Renal Replacement Therapy

Abstract

Objective: To compare effects of predialytic and intradialytic oral nutritional supplementation on adequacy of hemodialysis.

Study Design: Quasi-experimental study.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, Pakistan, from Jun to Aug 2023.

Methodology: Patients on hemodialysis were consecutively recruited. In the first arm (two sessions), patients were given 200ml of oral NOVASOURCE® Renal two hours into dialysis sessions, whereas in the second arm (another two sessions), this was given an hour before starting the session. Serum urea levels were checked at the start and end of each dialysis session. Ultrafiltration volumes were recorded, and post-dialysis weight was noted. All patients were monitored for intradialytic hypotension. Kt/V by Daugirdas equation and urea reduction ratios were calculated.

Results: Twenty patients with a median age of 57.50 years (interquartile range 35.00- 64.25 years) underwent 80 hemodialysis sessions. Mean Kt/V was 1.42± 0.38 and 1.40± 0.34 with predialytic and intradialytic nutritional supplementation (p=0.852), with targets being achieved in 27 (67.50%) and 28 (70.00%) sessions, respectively (p=0.418). Urea reduction ratios were 66.43± 16.59% and 65.82± 17.22% with predialytic and intradialytic nutritional supplementation (p=0.869), with targets being achieved in 23 (57.50%) and 26 (65.00%) sessions, respectively (p=0.973). Intradialytic hypotension was seen in 1 (0.03%) and 3 (0.08%) sessions with predialytic and intradialytic nutritional supplementation (p =0.999).

Conclusion: Timing of nutritional supplementation does not affect adequacy of hemodialysis.

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