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Feeding during dialysis-risks and uncertainties.

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Summary

Eating during dialysis is debated. While some advocate for intradialytic meals to combat protein-energy wasting, evidence suggests risks like hypotension and reduced dialysis effectiveness. More research is needed to balance benefits against harms for dialysis patients.

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Area of Science:

  • Nephrology
  • Clinical Nutrition
  • Internal Medicine

Background:

  • Intradialytic nutrition during dialysis is a controversial practice.
  • Current policies and practices regarding eating during dialysis vary significantly worldwide.
  • Protein-energy wasting is a common concern in dialysis patients.

Purpose of the Study:

  • To evaluate the benefits and risks of allowing dialysis patients to eat during treatment.
  • To address the controversy surrounding intradialytic food consumption.
  • To highlight the need for definitive randomized trials.

Main Methods:

  • Review of interventional studies on intradialytic eating.
  • Analysis of clinical studies examining the impact on dialysis adequacy.
  • Assessment of randomized studies focusing on outcomes and risks.

Main Results:

  • Eating during dialysis may cause significant postprandial hypotension and increase mortality risk.
  • Intradialytic food intake can interfere with the adequacy of delivered dialysis.
  • Existing studies often fail to adequately balance potential benefits against risks.

Conclusions:

  • There is a potential for harm associated with eating during dialysis.
  • Definitive randomized trials are needed to balance the risks and benefits.
  • Focus should be on adequate nutrient intake during the interdialytic interval, not during dialysis.