A difference between day and night: protein intake improves after the transition from conventional to frequent nocturnal home hemodialysis

Karin Ipema, Cees van der Schans, Noortje Vonk, Jorien M de Vries, Ralf Westerhuis, Ellen Duym, Casper F M Franssen

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Malnutrition is an important cause of the excessive morbidity and mortality rate of dialysis patients. Frequent nocturnal home hemodialysis (NHHD) has many benefits compared with conventional thrice-weekly hemodialysis (CHD), due to the virtual absence of dietary restrictions and a much higher overall dialysis efficiency. In this observational study, we investigated whether these benefits of NHHD translate into an improved nutritional intake, with a special emphasis on protein intake.

METHODS: We prospectively assessed the effect of the transition of CHD to NHHD on nutritional intake (5-day dietary intake journal), normalized protein catabolic rate, and anthropometric parameters in 15 consecutive patients who started NHHD in our center between 2004 and 2009 and completed at least 8 months of follow-up. Data were collected before the transition from CHD to NHHD and 4 and 8 months after the transition.

RESULTS: Protein intake, as measured by both dietary intake journal and normalized protein catabolic rate, increased significantly after the transition from CHD to NHHD. Accordingly, phosphate intake increased significantly; however, serum phosphate levels did not increase, despite negligible phosphate binder use during NHHD. Body mass index and upper arm muscle circumference did not change significantly.

CONCLUSION: The transition from CHD to NHHD has a positive effect on nutritional intake, in particular, protein intake. NHHD should be considered in malnourished patients on CHD.

Original languageEnglish
Pages (from-to)365-72
Number of pages8
JournalJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
Issue number3
Publication statusPublished - 2012



  • dietary proteins
  • dietetics
  • hemodialysis, home
  • malnutrition
  • phosphates
  • renal dialysis

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