Relationship of a food intake during hemodialysis and symptomatic intradialytic hypotension

Hemodial Int. 2021 Mar 10. doi: 10.1111/hdi.12923. Online ahead of print.

Abstract

Introduction: Intradialytic hypotension is the most common complication during hemodialysis and is associated with increased cardiovascular disease, mortality, and overall hospital admissions. We analyzed the influence of food intake during hemodialysis on intradialytic hypotension.

Methods: A total of 105 patients treated with chronic hemodialysis were observed for 8 weeks-4 weeks with a meal during hemodialysis and 4 weeks without a meal.

Findings: A statistically significant decrease of hypotensive events (p < 0.001) and cramping episodes (p = 0.035) was observed during a 4-week period without a meal. Patients who were particularly susceptible to intradialytic hypotension were those who were diabetic, had low urinary excretion, and were treated with hemodialysis for a long time. On a follow up, there was a significant increase in serum albumin after 3 months (p = 0.01) and 6 months (p = 0.036) despite meal withdrawal during hemodialysis.

Discussion: Fasting during hemodialysis may cause a significantly lower frequency of intradialytic hypotension and cramping episodes without affecting the nutritional status.

Keywords: food intake during hemodialysis; hemodialysis; intradialytic hypotension.