29 November 2024 : Clinical Research
Effects of Nutritional Protocol Changes on Hemodialysis Adequacy and Patient Health During the COVID-19 Pandemic
Cebrail Karaca
1ABCDEF*, Safak Mirioglu 2DEF, Aydan Mutis Alan 3CD, Saadet Usakli 4AB, Beyza Nur Aydin Keskin 4AB, Mehmet Erdem 4AB, Ahmet Murt 3F, Mevlut Tamer Dincer 3EF, Nurhan Seyahi 3AE, Sinan Trabulus 3AE
DOI: 10.12659/MSM.946471
Med Sci Monit 2024; 30:e946471
Table 2 Laboratory and clinical outcomes of the patients by feeding status during dialysis.
| Characteristics and Outcomes | Feeding | No-feeding | P |
|---|---|---|---|
| Dry weight (kg), mean±SD | 65.7±14.2 | 65.4±13.7 | 0.62 |
| Body mass index (kg/m), mean±SD | 24.7±5.0 | 24.4±4.89 | 0.11 |
| Predialytic systolic blood pressure (mmHg), median (IQR) | 140 (130–140) | 130 (120–140) | * |
| Predialytic diastolic blood pressure (mmHg), median (IQR) | 80 (80-80) | 80 (80-80) | * |
| Predialytic mean arterial pressure (mmHg), median (IQR) | 100 (97–100) | 97 (93–100) | * |
| Dialysate sodium (mEq/L), median (IQR) | 138 (138–140) | 138 (138–140) | 0.059* |
| Blood flow (mL/min), median (IQR) | 350 (320–350) | 360 (350–380) | * |
| Dialysate calcium (mmol/L), median (IQR) | 1.25 (1.25–1.5) | 1.25 (1.25–1.5) | * |
| Alpha-blocker use, n (%) | 12 (16) | 11 (15) | 0.82 |
| Beta-blocker use, n (%) | 20 (27) | 17 (23) | 0.57 |
| ACEI or ARB use, n (%) | 6 (8) | 4 (5) | 0.51 |
| Calcium-channel-blocker use, n (%) | 12 (16) | 15 (20) | 0.52 |
| Diuretic use, n (%) | 0 | 1 (1) | 0.31 |
| Hemodialysis vascular access | 0.21 | ||
| Arteriovenous fistula, n (%) | 69 (90.8) | 71 (93.4) | |
| Arteriovenous graft, n (%) | 1 (1.3) | 3 (3.9) | |
| Tunneled central venous catheter, n (%) | 6 (7.9) | 2 (2.7) | |
| Urea (mg/dL), mean±SD | 161.5±33.1 | 158±30.3 | 0.43 |
| Serum creatinine (mg/dL), median (IQR) | 8.7 (7.4–10.4) | 8.3 (7.3–10.8) | 0.96* |
| Potassium (mmol/L), median (IQR) | 5.0 (4.5–5.5) | 5.1 (4.6–5.4) | 0.32* |
| Calcium (mg/dL), median (IQR) | 8.8 (8.4–9.0) | 9.1 (8.8–9.7) | * |
| Uric acid (mg/dL), median (IQR) | 7.1 (6.6–7.8) | 7.2 (6.5–8.2) | 0.94* |
| Phosphate (mg/dL), mean±SD | 5.2±1.2 | 5.2±1.2 | 0.80 |
| Albumin (g/dL), median (IQR) | 3.9 (3.8–4.1) | 4.0 (3.9–4.2) | * |
| CRP (mg/L), median (IQR) | 6.4 (1.9–17.8) | 6.8 (1.6–12.2) | 0.17* |
| Parathyroid hormone (ng/L), median (IQR) | 484 (253.3–911.8) | 314.5 (141.3–536.8) | * |
| Transferrin saturation (%), median (IQR) | 27 (21–33.7) | 25.5 (18.2–37) | 0.91* |
| Ferritin (pg/L) | 686.3±408.9 | 920.4±474.6 | |
| Total cholesterol (mg/dL), mean±SD | 160.6±40.7 | 157.9±41.03 | 0.47 |
| LDL-cholesterol (mg/dL), median (IQR) | 86.5 (64–111) | 86 (68.2–110) | 0.42* |
| HDL-cholesterol (mg/dL), median (IQR) | 32 (28–39) | 33 (26–39) | 0.95* |
| Triglycerides (mg/dL), median (IQR) | 182.5 (122.5–249.5) | 159.5 (107.5–196) | * |
| White blood cell count (10/mm), mean±SD | 5.4±1.5 | 4.8±1.6 | |
| Hemoglobin (g/dL), mean±SD | 11.8±1.1 | 12.07±1.5 | 0.11 |
| Platelets (10/mm), median (IQR) | 201 (157–241.7) | 174 (136.5–211) | * |
| Urea reduction ratio (%), median (IQR) | 71 (68–75) | 72.5 (69–76) | * |
| spKt/V, mean±SD | 1.52±0.26 | 1.59±0.23 | |
| Ultrafiltration (mL per session), mean±SD | 2701.6±825.2 | 2930.6±777.3 | |
| Ultrafiltration rate (mL/h/kg), mean±SD | 10.4±3.2 | 11.4±3.0 | |
| Number of intradialytic hypotension per month, mean±SD | 1.4±1.2 | 0.81±0.86 | |
| Number of intradialytic hypotension per 6 months, median (IQR) | 7 (3–12.2) | 3 (1–7) | * |
| ACEI – angiotensin-converting enzyme inhibitor; ARB – angiotensin receptor blocker; CRP – C-reactive protein; IQR – interquartile range; LDL – low-density lipoprotein; HDL – high-density lipoprotein; SD – standard deviation; spKt/V – single-pool Kt/V. * Calculated with Wilcoxon signed-rank test; -test was applied in the remaining comparisons. | |||