Effects of calorie and fluid intake on adverse events during hemodialysis

Strong, Jennifer; Burgett, Marlys; Buss, Mary Lou; Carver, Michelle; Kwankin, Shalini; Walker, Dalene

doi:10.1016/s1051-2276(01)51664-7

Cited by 19 publications

(18 citation statements)

References 3 publications

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“…Also, Strong et al, 25 confirmed the fact that, food intake during hemodialysis caused hypotension significantly. In contrast, as a results of a large study, Benaroia et al, 26 studied on 126 hemodialysis patients.…”

Section: Discussionmentioning

confidence: 86%

Effect of Mealtime During Hemodialysis on Patients’ Complications

Borzou¹,

Mahdipour²,

Oshvandi³

et al. 2016

J Caring Sci

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Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients’ complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was conducted in two sessions. At both sessions, patients were kept fasting prior to hemodialysis. In the first session, after one hour and in the second session after two hours of hemodialysis, a meal containing 350 kcal of energy was given to the patients. Blood pressure and intensity of nausea and vomiting was measured and recorded immediately before the start of hemodialysis, and then every half an hour before the termination of the hemodialysis. Results: The results showed that in both sessions, food intake caused a drop in the systolic and diastolic blood pressure, but changes in the mealtime had no effect on the systolic and diastolic blood pressure. Also, statistical test showed that changes in the mealtime had no significant impact on the intensity of nausea and vomiting. Conclusion: Food intake during hemodialysis had no effect on the nausea and vomiting, but caused a drop in the systolic and diastolic blood pressure, the drop continued for one hour and one and a half hour after the meal. It is suggested, mealtime in the early hours of hemodialysis could be better managed during the hemodialysis process.

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Section: Discussionmentioning

confidence: 86%

Effect of Mealtime During Hemodialysis on Patients’ Complications

Borzou¹,

Mahdipour²,

Oshvandi³

et al. 2016

J Caring Sci

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“…There is little doubt that intra-dialytic food intake can trigger hypotensive episodes in end-stage renal disease patients [15]. However, this response is far from being uniform in all patients and seems to depend on the amount of food ingested, on the volume status and on the rate of concomitant ultrafiltration [16].…”

Section: Discussionmentioning

confidence: 99%

Online Kt/V Monitoring in Haemodialysis by UV Absorbance: Variations during Intra-Dialytic Meals

et al. 2014

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Background/Aims: The aim of this study was to analyse if intra-dialytic food intake may lead to changes in online Kt/V. Methods: Forty patients were analysed using haemodialysis machines with integrated online Kt/V monitoring based on UV absorbance or ionic dialysance. Kt/V was monitored before, during and after food intake. Samples of dialysate were analysed for urea, uric acid, creatinine and glucose levels. Results: Food intake was associated with a significant decrease in relative Kt/V when determined by UV absorbance. The drop in Kt/V was independent of changes in blood pressure or body posture. No significant changes in online Kt/V were found using the ionic dialysance method. Dialysate samples showed a continuous clearance of urea, uric acid and creatinine during meals but a rapid increase in glucose. Conclusion: Our data suggest that the short meal-associated decrease in online Kt/V as measured by UV absorbance does not represent a true decline in Kt/V but might reflect an intermittent increase in UV-absorbing dialysed solutes.

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“…1 Food ingestion during HD has been associated with a decline in blood pressure (BP). 4 This can lead to hypotension by: (1) increasing splanchnic sequestration of blood and a reduction in cardiac output or (2) through a decrease in splanchnic resistance leading to a reduction in systemic vascular resistance. 4 This can lead to hypotension by: (1) increasing splanchnic sequestration of blood and a reduction in cardiac output or (2) through a decrease in splanchnic resistance leading to a reduction in systemic vascular resistance.…”

Section: Introductionmentioning

confidence: 99%

“…3,5 Additionally, HD patients may have an increased incidence of autonomic dysfunction and a blunted response to hemodynamic stressors such as ultrafiltration. 3,4 The primary objective of this study was to estimate the OI in a population of stable HD patients. 3,4 The primary objective of this study was to estimate the OI in a population of stable HD patients.…”

Section: Introductionmentioning

confidence: 99%

Oral intake during hemodialysis: Is there an association with intradialytic hypotension?

Benaroia

Iliescu

2008

Hemodialysis International

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Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD. This is a cross-sectional retrospective chart review study of 3 consecutive HD runs (dialysate iCa=1.25 mmol/L) in 126 stable HD patients (n=378). For each run, the calculation for OI=total ultrafiltration-(net weight loss+IV fluids given). Hypotension was defined as a systolic blood pressure of <100 mmHg at any point during the run. The mean age of the patients was 60.9 years, 38.2% were female, 30.2% had diabetes mellitus, and the majority were Caucasian. The mean (SD) OI was 0.27 (0.352) L/run, range -1.061 to 1.901 L/run, with a normal distribution. In bivariate analysis, there was no correlation of OI with systolic blood pressure, diastolic blood pressure, or mean blood pressure (BP), and the mean OI did not differ among runs with hypotension (n=78) compared with uncomplicated runs (p=0.93). Oral intake was not predictive of hypotension in a multiple logistic regression model controlling for vintage, age, sex, BP medications, coronary disease, dialysis day and shift, diabetes mellitus, s-Ca, Na and ultrafiltration profiles, and dialysis temperature, even when the analysis was restricted to runs where the patients reached the prescribed dry weight within 0.1 kg. The results of this study suggest that the mean OI during dialysis is just over 0.25 kg, with some patients consuming several kilograms. The clinical significance of OI is uncertain. We did not find an association between OI and hypotension. It is likely that this association was confounded by failure to achieve the prescribed dry weight in a proportion of patients with a high OI, as well as interventions implemented in response to hypotension in previous runs. For example, patients with previous episodes of low BP are advised to limit OI, are prescribed profiles, and so on. There may be other deleterious effects of high OI including hypertension and cardiac disease. The generalizability of the results of this largely Caucasian study population is a recognized limitation. Further prospective and blinded studies are needed to examine the association between OI and hypotension, the long-term clinical consequences of OI, and to define thresholds for recommended OI during dialysis.

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Effects of calorie and fluid intake on adverse events during hemodialysis

Cited by 19 publications

References 3 publications

Effect of Mealtime During Hemodialysis on Patients’ Complications

Effect of Mealtime During Hemodialysis on Patients’ Complications

Online Kt/V Monitoring in Haemodialysis by UV Absorbance: Variations during Intra-Dialytic Meals

Oral intake during hemodialysis: Is there an association with intradialytic hypotension?

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