Impact of Blood Flow Rate and Duration of Dialysis Session on Nutritional Status in Hemodialysis Patients.

Abstract

<b>Background.</b> Chronic kidney disease (CKD) was commonly associated with malnutrition, with many patients exhibiting protein-energy deficiency and muscle wasting. Increasing blood flow rate (BFR) and extending dialysis duration had been considered strategies to improve nutritional outcomes in CKD stage 5 patients on maintenance hemodialysis. <b>Aim.</b> The study aimed to evaluate the effect of increased BFR and prolonged dialysis duration on the nutritional status of CKD stage 5 patients undergoing maintenance hemodialysis. <b>Materials and Methods.</b> This prospective randomized controlled study was conducted from 1st August to 1st October 2023 in a tertiary care centre. Ninety patients were randomized into three groups: Group 1 received BFR 250-300 mL/min for 4 hours; Group 2 received the same BFR for 5 hours; and Group 3 received BFR 300-350 mL/min for 4 hours. Nutritional assessments included serum albumin, BMI, Subjective Global Assessment (SGA), mid-arm muscle circumference (MAMC), triceps skinfold thickness (TSFT), and body composition monitoring (BCM), performed at baseline and after 3 months. <b>Results.</b> Significant improvements in SGA were observed between Group 1 and Group 2 (p = 0.035) and between Group 1 and Group 3 (p = 0.018). BCM also showed significant variation between Group 1 and both intervention groups (p = 0.015). No significant differences were found in MAMC, TSFT, or albumin categories. Group 2 demonstrated improvements in SGA, BCM, and urea, while Group 3 showed improvements in SGA, BCM, urea, and serum albumin. <b>Conclusion.</b> Increased BFR and longer dialysis duration positively influenced nutritional status, with higher BFR demonstrating the most notable benefit.