Browsing by Author "Usakli, Saadet"

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Effect of Intradialytic Dietary Support on Nutritional Status, Muscle Strength, and Clinical Markers in Patients on Hemodialysis: a Cross-Sectional Study
(Bmc, 2025) Usakli, Saadet; Mirioglu, Safak; Dincer, Mevlut Tamer; Karatas, Beril; Karaca, Cebrail
Background Intradialytic nutritional support influences nutritional status, muscle strength, and related clinical outcomes in patients undergoing hemodialysis (HD). This study aims to compare the effects of intradialytic nutrition on patient outcomes, malnutrition and sarcopenia risks, and handgrip strength (HGS) in HD patients. Methods A cross-sectional study was conducted involving 129 HD patients (62 receiving intradialytic nutritional support and 67 not) from two HD centers located in the same geographic region. Nutritional status was assessed using the MNA-SF, while physical performance was evaluated with SARC-F and HGS. Biochemical markers, including serum albumin, phosphorus, potassium, and hemoglobin (Hb) levels, were measured. Results The group receiving intradialytic nutritional support had significantly higher serum albumin (4.0 [3.7-4.2] g/dL vs. 3.5 [3.2-3.7] g/dL; p < 0.001, respectively) and potassium levels (5.6 [5.1-6.2] mmol/L vs. 5.0 [4.7-5.4] mmol/L; p < 0.001, respectively) compared to the group not receiving support. Phosphorus levels were similar between the two groups (4.8 [3.8-6.1] mg/dL vs. 5.3 [4.5-5.2] mg/dL; p = 0.059, respectively). The nutritional support group had lower Hb levels (10.9 +/- 1.7 g/dL vs. 11.8 +/- 2.0 g/dL; p = 0.008, respectively) and required higher doses of erythropoiesis-stimulating agents (32.0 [24.0-48.0] IU/monthx10(3) vs. 24.0 [18.0-33.0] IU/monthx10(3); p = 0.046, respectively). No significant differences were observed between the groups for MNA-SF and SARC-F scores (13.0 [12.0-14.0] vs. 14.0 [12.0-14.0]; p = 0.608, 5.0 [3.0-7.0] vs. 4.0 [2.0-6.0]; p = 0.053, respectively). The number of patients below the HGS cut-off (27/16 kg) was significantly lower in the nutritional support group (25 [40.3%] vs. 40 [59.7%]; p = 0.028, respectively), and the difference between groups was more pronounced in male patients in terms of median handgrip strength values. The nutritional support group had a higher rate of receiving social financial assistance (45 [72.6%] vs. 37 [55.2%]; p = 0.041) and a higher weekly protein intake. Conclusion Intradialytic nutritional support was associated with higher serum albumin levels and handgrip strength, with the latter being more prominent among male patients. However, potassium levels were found to be higher in the nutritional support group, which may present a clinical concern and warrants further monitoring. No significant differences were observed in malnutrition or sarcopenia risk. These findings highlight the potential benefits and limitations of intradialytic nutritional interventions and provide a basis for future prospective studies.
Effects of Nutritional Protocol Changes on Hemodialysis Adequacy and Patient Health During the Covid-19 Pandemic
(int Scientific information, inc, 2024) Karaca, Cebrail; Mirioglu, Safak; Alan, Aydan Mutis; Usakli, Saadet; Keskin, Beyza Nur Aydin; Erdem, Mehmet; Trabulus, Sinan
Background: During the COVID-19 pandemic, strict feeding restrictions were implemented in many dialysis centers to minimize transmission between patients. This study aims to evaluate the effects of these feeding restrictions on dry weight, intradialytic hypotension (IDH), and dialysis adequacy in hemodialysis patients. Material/Methods: In this retrospective single-center study involving 76 hemodialysis patients, data from 2 consecutive 6-month periods were analyzed: the first before the COVID-19 pandemic when intradialytic nutrition was supported, and the second during the pandemic when intradialytic nutrition was restricted. Data from the patients' monthly visits during both periods were evaluated, averages were recorded, and a comparison was made between the Results: The frequency of IDH was significantly higher during the feeding period compared with the no-feeding period (1.4 +/- 1.2/month vs 0.81 +/- 0.86/month, P=0.01). Conversely, the urea reduction ratio was greater in the no-feeding period [72.5% (69-76) vs 71% (68-75), P=0.01], as were the single-pool Kt/V values (1.59 +/- 0.23 vs 1.52 +/- 0.26, P=0.004) and ultrafiltration rates (mL/h/kg) (11.4 +/- 3.0 vs 10.4 +/- 3.2, P=0.01). However, the dry weight of the patients was similar in the 2 periods (65.4 +/- 13.7 kg vs 65.7 +/- 14.2 kg, P=0.62). Conclusions: During the COVID-19 pandemic, mandatory feeding restrictions for hemodialysis patients, aimed at reducing transmission, were linked to a decrease in IDH frequency and improved dialysis adequacy. However, no significant reduction in patients' dry weights was observed.