Stability of nutritional parameters during a 5-year follow-up in patients treated with sequential long-hour hemodialysis

Progressive nutritional impairment has been recently reported during conventional hemodialysis (HD) treatment. We studied the nutritional parameters during a 5-year follow-up in HD patients. Thirty-three patients (15F/18M; 65 years old at the study start) filled out a 3-day food questionnaire once a year between 1995 and 1999 (study group). Twenty patients, who did not fill out the food records during this period served as a control group (control group). The food record was run by the renal dietician using a dedicated software, providing daily energy and protein intakes (DEI and DPI). Serum albumin, normalized protein equivalent of nitrogen appearance (nPNA), and postdialysis body weight (BW) at the time of food record were collected in the study group and from the patient chart in the control group. The energy intake in the study group and the protein intake in both groups were close to the recommended intakes in ESRD patients. Protein intake assessed from food questionnaire or from urea kinetics were not statistically different. Using ANOVA for repeated measures, no difference along the 5 years was found for daily energy intake, daily protein intake, nPNA, and BW in the study group. The BW and nPNA remained stable in the control group. Hence, this study does not confirm the progressive nutritional impairment reported in the HEMO study, whereas the patients' age and vintage are largely higher in the present study. The role of a large dialysis dose in maintaining nutritional status in HD patients is discussed.