Does more frequent hemodialysis provide dietary freedom?

Abstract

Proponents of more frequent hemodialysis have suggested that this modality may improve nutritional status. A review of trials performed in the past 10 years was carried out to substantiate this claim. Three daily hemodialysis trials and 5 nocturnal hemodialysis trials were identified. More frequent hemodialysis did not appear to consistently improve serum albumin levels, weight after dialysis, protein catabolic rate, or protein or energy intake as measured by food diaries, except in 1 study with an average duration of conventional dialysis of 9.8 years before patients were switched to short daily hemodialysis and a mean follow-up of 39 months. There was an improvement in serum phosphorus levels and a decline in the use of phosphate binders, particularly in participants who received nocturnal hemodialysis. Thus, most short-term studies of more frequent dialysis do not show significant benefits in improving nutritional status. Nutritional benefits may accrue with longer follow-up or long-term dialysis, or both.