[F-PO1495] In-Center Nocturnal Hemodialysis Patients Show Improved Protein and Phosphorus Status

Deborah A. Benner, Robert Provenzano, Karen Spach, Allen R. Nissenson DaVita National Nutrition, Inc., Irvine, CA; Office of the Chief Medical Officer, DaVita, Inc., Lakewood, CO; DaVita Clinical Research, Minneapolis, MN

Introduction: Providing adequate protein without precipitating hyperphosphatemia poses a major and ongoing challenge for managing nutrition in chronic hemodialysis patients.
Methods: To evaluate the effect of in-center nocturnal hemodialysis (NHD) on nutrition and hyperphosphatemia, we compared patients undergoing NDH to those undergoing in-center conventional hemodialysis (ICHD) using a cross-sectional design and patient laboratory values from a single time point.
Results: There were 638 patients in the NHD group and 90,267 in the ICHD group. Serum albumin levels were significantly higher in NHD patients compared to ICHD patients (3.93 0.02 vs. 3.84 0.01 g/dl respectively, p<0.05) and a significantly higher percent of NHD patients achieved albumin levels of 3.5 g/dl (91 14%) vs. ICHD (82 1%, p<0.05). Significantly more NHD patients achieved adequate serum PO₄ ( 5.5 mg/dl) (65 8%) compared to ICHD (63 1%, p<0.05) while serum calcium levels did not differ significantly between the two populations.
Conclusions: Our findings in a large population of patients are consistent with the hypothesis that NHD, unlike ICHD, permits adequate protein intake without exacerbating hyperphosphatemia. 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.

Friday, October 30, 2009 10:00 AM

Poster Session: Dialysis: Epidemiology, Outcomes, and Clinical Trials: Non-Cardiovascular II (10:00 AM-12:00 PM) Poster Board Number: F-PO1495

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