Nutritional Status of Twice and Thrice-Weekly Hemodialysis Patients with Weekly Kt/V > 3.6
Ouppatham Supasyndh MD*, Bancha Satirapoj MD*, Sudarat Seenamngoen MD*, Somchai Yongsiri MD*, Punbuppa Choovichian MD*, Supat Vanichakarn MD**
Affiliation : * Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ** The National Kidney Foundation of Thailand, Bangkok, Thailand
Background : Multiple lines of evidence have indicated that the dose of hemodialysis (HD) affects patient
outcome. According to K-DOQI, daily spKt/V > 1.2 predicts the morbidity and mortality among thrice-weekly
HD. However, in developing countries, about three-fourths of end stage renal disease patients undergo twice-
weekly HD. No data studied the outcome and nutritional status between twice- and thrice-weekly HD patients.
Objective : To compare the nutritional parameters in twice- and thrice-weekly HD patients who had weekly
Kt/V > 3.6
Material and Method: The cross-sectional study was performed in the HD unit of the National Kidney Foundation
of Thailand. One hundred and forty two informed consent HD patients were enrolled in the present study.
Nutritional status was evaluated following a HD treatment by bioelectrical impedance analysis. All patients
were interviewed for three-day food record and data were analyzed by Inmucal software program.
Results : Sixty patients had thrice-weekly HD and 82 patients were on twice-weekly HD. The characteristics
and duration of dialysis of both groups were similar except age. Duration of dialysis in thrice-weekly HD
group was 82.64 + 50.82 and twice-weekly HD group was 68.92 + 31.49 months. The mean age of the thrice-
weekly HD group and twice-weekly HD group patients were 47.78 + 9.89 and 41.63 + 10.47 years, respectively
(p < 0.05). Between both groups, the student t-test showed no difference in nutrition parameters except daily
energy intake which was lower in the thrice-weekly HD group than twice-weekly HD group (19.21 + 6.42 vs.
25.02 + 7.70 kcal/kg/day, p < 0.05).
Conclusion : HD patients with delivered weekly Kt/V > 3.6, nutritional status of patients undergoing twice-
weekly HD are not different from that of thrice-weekly HD patients. Higher energy intake in twice-weekly HD
patients might be the explanation.
Keywords : Kidney failure, Chronic, Nutritional status, Renal dialysis, Time factors
