Nutritional Status in Nocturnal Hemodialysis Patients: A Systematic Review with Meta-Analysis

Karin J. R. Ipema; Simone Struijk; Annet van der Velden; Ralf Westerhuis; Cees P. van der Schans; Carlo A. J. M. Gaillard; Wim P. Krijnen; Casper F. M. Franssen

doi:10.1371/journal.pone.0157621

Nutritional Status in Nocturnal Hemodialysis Patients: A Systematic Review with Meta-Analysis

Karin J. R. Ipema^*, Simone Struijk, Annet van der Velden, Ralf Westerhuis, Cees P. van der Schans, Carlo A. J. M. Gaillard, Wim P. Krijnen, Casper F. M. Franssen

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background

Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition.

Study design

Systematic review with meta-analysis.

Population

NHD patients.

Search strategy

Systematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD.

Intervention

Transition from CHD to NHD.

Outcomes

Albumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake.

Results

Systematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4-6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4-6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73-2.53, p

Limitations

Most studies had moderate sample sizes; some had incomplete dietary records and relatively brief follow-up period. Studies markedly differed with regard to study design.

Conclusions

NHD is associated with significantly higher protein and energy intake as well as increases in serum albumin and nPCR. However, the data on body composition are inconclusive.

Original language	English
Article number	e0157621
Number of pages	19
Journal	PLoS ONE
Volume	11
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0157621
Publication status	Published - 20-Jun-2016

Keywords

QUALITY-OF-LIFE
IN-CENTER CONVERSION
STAGE RENAL-DISEASE
BODY-MASS INDEX
HOME HEMODIALYSIS
FREQUENT HEMODIALYSIS
CONVENTIONAL HEMODIALYSIS
PHYSICAL FUNCTION
PROTEIN-INTAKE
3 TIMES

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@article{86754546df3748b4bb7eff07ed38fdf1,

title = "Nutritional Status in Nocturnal Hemodialysis Patients: A Systematic Review with Meta-Analysis",

abstract = "BackgroundHemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition.Study designSystematic review with meta-analysis.PopulationNHD patients.Search strategySystematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD.InterventionTransition from CHD to NHD.OutcomesAlbumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake.ResultsSystematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4-6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4-6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73-2.53, pLimitationsMost studies had moderate sample sizes; some had incomplete dietary records and relatively brief follow-up period. Studies markedly differed with regard to study design.ConclusionsNHD is associated with significantly higher protein and energy intake as well as increases in serum albumin and nPCR. However, the data on body composition are inconclusive.",

keywords = "QUALITY-OF-LIFE, IN-CENTER CONVERSION, STAGE RENAL-DISEASE, BODY-MASS INDEX, HOME HEMODIALYSIS, FREQUENT HEMODIALYSIS, CONVENTIONAL HEMODIALYSIS, PHYSICAL FUNCTION, PROTEIN-INTAKE, 3 TIMES",

author = "Ipema, {Karin J. R.} and Simone Struijk and {van der Velden}, Annet and Ralf Westerhuis and {van der Schans}, {Cees P.} and Gaillard, {Carlo A. J. M.} and Krijnen, {Wim P.} and Franssen, {Casper F. M.}",

year = "2016",

month = jun,

day = "20",

doi = "10.1371/journal.pone.0157621",

language = "English",

volume = "11",

journal = "PLOS-One",

issn = "1932-6203",

publisher = "PUBLIC LIBRARY SCIENCE",

number = "6",

}

TY - JOUR

T1 - Nutritional Status in Nocturnal Hemodialysis Patients

T2 - A Systematic Review with Meta-Analysis

AU - Ipema, Karin J. R.

AU - Struijk, Simone

AU - van der Velden, Annet

AU - Westerhuis, Ralf

AU - van der Schans, Cees P.

AU - Gaillard, Carlo A. J. M.

AU - Krijnen, Wim P.

AU - Franssen, Casper F. M.

PY - 2016/6/20

Y1 - 2016/6/20

N2 - BackgroundHemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition.Study designSystematic review with meta-analysis.PopulationNHD patients.Search strategySystematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD.InterventionTransition from CHD to NHD.OutcomesAlbumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake.ResultsSystematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4-6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4-6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73-2.53, pLimitationsMost studies had moderate sample sizes; some had incomplete dietary records and relatively brief follow-up period. Studies markedly differed with regard to study design.ConclusionsNHD is associated with significantly higher protein and energy intake as well as increases in serum albumin and nPCR. However, the data on body composition are inconclusive.

AB - BackgroundHemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition.Study designSystematic review with meta-analysis.PopulationNHD patients.Search strategySystematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD.InterventionTransition from CHD to NHD.OutcomesAlbumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake.ResultsSystematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4-6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4-6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73-2.53, pLimitationsMost studies had moderate sample sizes; some had incomplete dietary records and relatively brief follow-up period. Studies markedly differed with regard to study design.ConclusionsNHD is associated with significantly higher protein and energy intake as well as increases in serum albumin and nPCR. However, the data on body composition are inconclusive.

KW - QUALITY-OF-LIFE

KW - IN-CENTER CONVERSION

KW - STAGE RENAL-DISEASE

KW - BODY-MASS INDEX

KW - HOME HEMODIALYSIS

KW - FREQUENT HEMODIALYSIS

KW - CONVENTIONAL HEMODIALYSIS

KW - PHYSICAL FUNCTION

KW - PROTEIN-INTAKE

KW - 3 TIMES

U2 - 10.1371/journal.pone.0157621

DO - 10.1371/journal.pone.0157621

M3 - Review article

C2 - 27322616

SN - 1932-6203

VL - 11

JO - PLOS-One

JF - PLOS-One

IS - 6

M1 - e0157621

ER -