Kidney Week

Abstract: SA-PO1060

Impact of Dialysis Treatment Shift on Malnutrition Indicators

Session Information

• Diet and Nutrition: Clinical
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Carrero, Juan Jesus, European Renal Nutrition working group, ERA-EDTA, Italy

Juan Jesus Carrero,

• Zawada, Adam M., Fresenius Medical Care, Bad Homburg, Germany

Adam M. Zawada,

• Brand, Katharina, Fresenius Medical Care, Bad Homburg, Germany

Katharina Brand,

• Stuard, Stefano, Fresenius Medical Care, Bad Homburg, Germany

Stefano Stuard,

• Canaud, Bernard J., Fresenius Medical Care, Bad Homburg, Germany

Bernard J. Canaud,

• Gauly, Adelheid, Fresenius Medical Care, Bad Homburg, Germany

Adelheid Gauly,

• Winter, Anke, Fresenius Medical Care, Bad Homburg, Germany

Anke Winter,

• Fouque, Denis, European Renal Nutrition working group, ERA-EDTA, Italy

Denis Fouque,

Background

Malnutrition is strongly associated with morbidity and mortality among hemodialysis patients. It has been a long-term clinical concern that patients on afternoon shifts (AS) are more prone to malnutrition than those on morning shifts (MS), as their dialysis scheme and post-dialysis symptoms interfere with their meal intake. Thus, we evaluate the role of dialysis shifts on malnutrition indicators.

Methods

We conducted a retrospective study among 9.963 incident hemodialysis NephroCare patients using 2011-2016 European Clinical Database data. Linear mixed models were used to compare the course of Body Composition Monitor assessed lean and fat tissue index (LTI, FTI) between MS and AS patients over 2 years. These models included fixed effects (age, sex, vascular access, diabetes mellitus) and random effects (country, patient). Secondary malnutrition indicators were body mass index, albumin, creatinine and normalized protein catabolic rate.

Results

Patients had a mean age of 63.6 years, 41.8% were female and 29.9% were diabetic.
Mean baseline LTI and FTI levels were comparable between MS (LTI: 12.5±2.9kg/m²; FTI: 13.7±6.0kg/m²) and AS (LTI: 12.4±2.9kg/m²; FTI: 13.2±6.1kg/m²) patients. During follow-up LTI slightly decreased and FTI constantly increased in both groups with a mean absolute change (baseline-24months) of -0.3 kg/m² for LTI and +1.0 kg/m² for FTI (Figure 1). The course of these malnutrition indicators did not differ between dialysis shift groups (Treatment x time interaction p-values ≥0.10). We did not observe substantial differences between groups when descriptively evaluating secondary malnutrition indicators.

Conclusion

Dialysis shift does not seem to impact long-term nutritional status of dialysis patients and may not represent a modifiable risk factor.

Funding

• Commercial Support – Fresenius Medical Care