الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hemodialysis is a vital process in ESRD patients, with the goal of minimizing complications, reducing mortality rates, improving quality of life, treating PEW, and enhancing the nutritional status.
Medical nutritional therapy is cornerstone in the management of HD patients, however finding the balance between providing adequate energy and protein supply needed to abolish PEW without compromising the micronutrients level is hard to achieve and should be individualized according to the patient’s health status and needs.
New advances in HD management focus deeply on facilitating the process of care and improving patients’ QOL, with emphasis on utilizing the long-dialysis hours for proper patient education, assessment and management. Intradialytic feeding is more widely encouraged despite its possible drawbacks because of the highly coveted betterment of nutritional status.
The present study was carried out over a yearlong period starting from August 2021 to August 2022. A total of 150 patients were interviewed through a pre-structured questionnaire, blood samples were drawn from the patients pre, during and post dialysis and vital signs were measured every hour from the start to the end of the dialysis session. Half the patients were recruited from the Kidney and Urology Center (private hospital) and the other half were recruited from Almouassat hospital (governmental hospital).
The present study aimed to assess the nutritional status in HD patients and study their intradialytic dietary habits by grouping them to patients who eat during the dialysis session and those who do not, to identify the relation of intradialytic feeding to some of the most common complications of HD.
The results showed a significant statistical difference in energy and protein intake between the two groups on HD days; patients who ate during the dialysis session had significantly more energy and protein intake than those who didn’t eat during the session on HD days. The results also showed a significant negative correlation between MIS and energy intake, protein intake, body weight and BMI. There was not a significant statistical difference between the 2 groups in blood pressure nor heart rate measurments.
6.2. Conclusion
from the data of the present study, it can be concluded that intradialytic feeding has some positive effects like enhancement of energy and protein intake and evading hypoglycemia, and some negative effects like lower dialysis adequacy and undesired higher level of some micronutrients like potassium and phosphorus.
Whether it is a “lost opportunity” to provide supervised intradialytic meals with proper nutritional education and enhancement of nutritional status or an “unwanted risk” to subject the patient to hemodynamic instability and reduction in dialysis adequacy, intradialytic feeding should be an individualized approach weighing on risks and benefits and integrating nephrologists and nutritionists in the decision-making.
6.3. Recommendations
Based on the study findings, the following recommendations are suggested:
1- Proper patient education on the target energy, protein and micronutrient intake in HD and continuous surveying, monitoring and modification.
2- Individualizing the advice of intradialytic feeding according to the patient’s needs and present complications.
3- Larger studies should be conducted to identify proper intradialytic feeding practices for producing a more favorable outcome without compromising patient’s health.