Nocturnal Hemodialysis Improves Protein and Phosphorus Status

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Patients who undergo in-center nocturnal hemodialysis (NHD) have improved protein and phosphorus status compared with those treated with in-center conventional hemodialysis (ICHD).
  • Serum albumin levels were significantly higher in NHD patients compared with the ICHD group.
  • Results lend support to prospective clinical trials to assess whether NHD affords direct survival benefits to patients, concluded researchers.

Patients who undergo in-center nocturnal hemodialysis (NHD) have improved protein and phosphorus status compared with those treated with in-center conventional hemodialysis (ICHD), a study shows.

Deborah A. Benner, MA, RD, National Director of Nutrition Services for DaVita, Inc., and collaborators compared 638 NHD patients with 90,267 ICHD patients. Serum albumin levels were significantly higher in NHD patients compared with the ICHD group (3.93 vs. 3.84 g/dL). A significantly higher percentage of NHD patients than ICHD patients achieved albumin levels of 3.5 g/dL or higher (91% vs. 82%), the investigators reported.

In addition, 65% of NHD patients achieved adequate serum phosphate levels (5.5 mg/dL or less) compared with 63% for ICHD patients, a significant difference between the groups. Serum calcium levels did not differ significantly in the two groups.

“Our findings in a large population of patients are consistent with the hypothesis that NHD, unlike ICHD, permits adequate protein intake without exacerbating hyperphosphatemia,” the authors concluded. “Given the known relationship between malnutrition, hyperphosphatemia, and mortality, our results lend support to prospective clinical trials to assess whether NHD affords direct survival benefits to patients.”

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