Impact of Blood Flow Rate and Duration of Dialysis Session on Nutritional Status in Hemodialysis Patients.

Background. Chronic kidney disease (CKD) was commonly associated with malnutrition, with many patients exhibiting protein-energy deficiency and muscle wasting. Increasing blood flow rate (BFR) and extending dialysis duration had been considered strategies to improve nutritional outcomes in CKD stage 5 patients on maintenance hemodialysis. Aim. The study aimed to evaluate the effect of increased BFR and prolonged dialysis duration on the nutritional status of CKD stage 5 patients undergoing maintenance hemodialysis. Materials and Methods. This prospective randomized controlled study was conducted from 1st August to 1st October 2023 in a tertiary care centre. Ninety patients were randomized into three groups: Group 1 received BFR 250-300 mL/min for 4 hours; Group 2 received the same BFR for 5 hours; and Group 3 received BFR 300-350 mL/min for 4 hours. Nutritional assessments included serum albumin, BMI, Subjective Global Assessment (SGA), mid-arm muscle circumference (MAMC), triceps skinfold thickness (TSFT), and body composition monitoring (BCM), performed at baseline and after 3 months. Results. Significant improvements in SGA were observed between Group 1 and Group 2 (p = 0.035) and between Group 1 and Group 3 (p = 0.018). BCM also showed significant variation between Group 1 and both intervention groups (p = 0.015). No significant differences were found in MAMC, TSFT, or albumin categories. Group 2 demonstrated improvements in SGA, BCM, and urea, while Group 3 showed improvements in SGA, BCM, urea, and serum albumin. Conclusion. Increased BFR and longer dialysis duration positively influenced nutritional status, with higher BFR demonstrating the most notable benefit.