Effects of calorie and fluid intake on adverse events during hemodialysis

To investigate the incidence of adverse events during hemodialysis treatments as a function of calories and fluid intake.

The study period was August 3-26, 1999. Hemodialysis visits were studied. Twenty-three patients receiving hemodialysis during the 2nd shift on Tuesday, Thursday, and Saturday were studied. A total of 166 hemodialysis patient visits were studied. Data collected included: amount of fluid and food consumed, blood pressure levels, and mannitol use during each hemodialysis treatment; and any symptoms that occurred either during or after the dialysis treatment (hypotension, nausea, vomiting, diarrhea, cramping, and access problems).

Using regression analysis, calories and fluids were strong predictors of both hypotension (P =.003) and mannitol use (P =.000), but not of cramping or access problems. Patients were 3 times more likely to have hypotension if taking any fluids (P =.011). Patients consuming >200 calories were 2 times as likely to have hypotension (P =.058). Patients were 5 times more likely to use mannitol if taking any fluids (P =.005). Mannitol use increased significantly (P =.001) with those patients consuming >200 calories.

Patients who ate more than 200 calories and consumed more than 200 mL of fluid during hemodialysis had an increased incident of hypotensive events and increased use of mannitol.