Dergiler / Nefroloji Hemşireliği Dergisi / 2026 / Cilt: 21 Sayı: 2

Kronik Hemodiyaliz Tedavisi Alan Hastalarda İntradiyalitik Besin Alımının Semptom Sıklığı ve Şiddeti Üzerindeki Etkisi/ Impact of Intradialytic Food Intake on Symptom Frequency and Severity in Patients Undergoing Chronic Hemodialysis

Impact of Intradialytic Food Intake on Symptom Frequency and Severity in Patients Undergoing Chronic Hemodialysis/ Kronik Hemodiyaliz Tedavisi Alan Hastalarda İntradiyalitik Besin Alımının Semptom Sıklığı ve Şiddeti Üzerindeki Etkisi

Vacide Aşık Özdemir(RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ)0000-0001-6421-1518
Yağmur Akbal Demirci(RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ)0000-0001-6748-6701
Zeynep Pehlivan Köksal(RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ)0000-0002-7318-9153
Sayfa
103–114
Yayın Tarihi
2026-05-26
DOI
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Bulgular: Sonuçlara göre, intradiyalitik besin alımının olmadığı dönemde hastalarda en sık görülen semptomlar; üzgün hissetme (%16,7), baş ağrısı (%12,5), uykuya dalmada zorluk (%10,4), ayaklarda uyuşma ve karıncalanma (%10,4) ve yorgunluk/enerji eksikliği (%10,4) olmuştur.

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Amaç & Hipotez:Amaç: Bu çalışmada, kronik hemodiyaliz tedavisi gören hastalarda, intradiyalitik besin alımının semptomların sıklığı ve şiddeti üzerindeki etkisi araştırılmıştır.
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Temel Bulgular & Veri:Gereç ve Yöntem: Haziran-Eylül 2023 tarihleri arasında yürütülen bu çalışmaya, Türkiye'nin kuzeydoğusundaki bir kronik hemodiyaliz merkezinde tedavi gören 48 hasta katılmıştır.
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Sonuç & Katkı:Bulgular: Sonuçlara göre, intradiyalitik besin alımının olmadığı dönemde hastalarda en sık görülen semptomlar; üzgün hissetme (%16,7), baş ağrısı (%12,5), uykuya dalmada zorluk (%10,4), ayaklarda uyuşma ve karıncalanma (%10,4) ve yorgunluk/enerji eksikliği (%10,4) olmuştur.
🔬Tür:Araştırma Makalesi
📍Kapsam:2023 · 48 hasta
⚙️Değişkenler:Hemodiyaliz · İntradiyalitik Besin Alımı · Semptom

Özet

Amaç: Bu çalışmada, kronik hemodiyaliz tedavisi gören hastalarda, intradiyalitik besin alımının semptomların sıklığı ve şiddeti üzerindeki etkisi araştırılmıştır. Gereç ve Yöntem: Haziran-Eylül 2023 tarihleri arasında yürütülen bu çalışmaya, Türkiye'nin kuzeydoğusundaki bir kronik hemodiyaliz merkezinde tedavi gören 48 hasta katılmıştır. Araştırmacılar tarafından geliştirilen Tanıtıcı Bilgi Formu ve Diyaliz Semptom İndeksi kullanılarak hem diyaliz sırasında besin alımının olduğu hem de diyaliz sırasında besin alımının olmadığı dönemde yüz yüze görüşmeler yapılmıştır. Bulgular: Sonuçlara göre, intradiyalitik besin alımının olmadığı dönemde hastalarda en sık görülen semptomlar; üzgün hissetme (%16,7), baş ağrısı (%12,5), uykuya dalmada zorluk (%10,4), ayaklarda uyuşma ve karıncalanma (%10,4) ve yorgunluk/enerji eksikliği (%10,4) olmuştur. Buna karşılık, intradiyalitik besin alımının olduğu dönemde en sık bildirilen semptomlar cinselliğe karşı ilginin azalması ve cinsel olarak uyarılmada zorluk (%39,6), yorgunluk/enerji eksikliği (%27,1) ve sinirlilik hissi (%22,9) olmuştur. Ortalama toplam indeks puanı, intradiyalitik besin alımının olduğu dönemde besin alımının olmadığı döneme göre anlamlı derecede daha yüksekti (p<0,05) ve büyük bir etki büyüklüğüne sahipti (d=-0,84). Hastaların yaşı ile hem besin alımı yapılmayan dönemde (R=0,354, R2düzeltilmiş=0,086) hem de besin alımı döneminde (R=0,367, R2düzeltilmiş=0,096) ortalama index toplam puanları arasında anlamlı bir korelasyon bulunmuştur. Sonuç: İntradiyalitik besin alımı, aynı hastalarda yapılan karşılaştırmada daha yüksek semptom yükü ile ilişkili bulunmuştur.

Abstract

Aim: This study aimed to investigate the influence of intradialytic food intake on the frequency and severity of symptoms in patients undergoing chronic hemodialysis treatment. Materials and Methods: Conducted between June and September 2023, this study involved 48 patients receiving treatment at a chronic hemodialysis center in northeastern Turkey. Face-to-face interviews were conducted using the Informative Information Form and Dialysis Symptom Index developed by researchers, both during the period when food intake occurred during dialysis and during the period when food intake did not occur during dialysis. Results: According to the results, during the no-food intake, the most common symptoms included feeling sad (16.7%), headache (12.5%), trouble staying asleep (10.4%), numbness and tingling in the feet (10.4%), fatigue/ lack of energy (10.4%). In contrast, during the food intake, the most frequently reported symptoms were decreased interest in sex and difficulty in becoming sexually aroused (39.6%), fatigue/lack of energy (27.1%), and feeling irritable (22.9%). The mean total index score was significantly higher in the food intake period than in no-food intake period (p<0.05), with a large effect size (d=-0.84). A significant correlation correlation was found between patients’ age and mean index total scores in both the no-food intake (R=0.354, R2adjusted=0.086) and food intake (R=0.367, R2adjusted=0.096) periods. Conclusion: Intradialytic nutrient intake was found to be associated with a higher symptom burden in a comparison of the same patients.

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Bu Makaleye Atıf Yap

Özdemir, V. A., Demirci, Y. A., Köksal, Z. P. (2026). Kronik Hemodiyaliz Tedavisi Alan Hastalarda İntradiyalitik Besin Alımının Semptom Sıklığı ve Şiddeti Üzerindeki Etkisi/ Impact of Intradialytic Food Intake on Symptom Frequency and Severity in Patients Undergoing Chronic Hemodialysis. Nefroloji Hemşireliği Dergisi, Cilt: 21 Sayı: 2, 103–114. https://ajindex.com/articles/1120953

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Kaynakça (32)

  1. Sabatino A, Piotti G, Cosola C, Gandolfini I, Kooman JP, Fiaccadori E. Dietary protein and nutritional supplements in conventional hemodialysis. Semin Dial. 2018;31(6):583-91. https://doi.org/10.1111/sdi.12730.
  2. Ikizler TA, Burrowes JD, Byham-Gray LD, Teta D, Yee-Moon Wang A, Cuppari L. KDOQI clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1-107. https://doi.org/10.1053/j.ajkd.2020.05.006.
  3. Kalantar-Zadeh K, Ikizler TA. Let them eat during dialysis: an overlooked opportunity to improve outcomes in maintenance hemodialysis patients. J Ren Nutr. 2013;23(3):157-63. https://doi.org/10.1053/j.jrn.2012.11.001.
  4. De D, Xiang Ai AT. Standardising haemodialysis care by restricting nutrition during dialysis: introducing a quality improvement initiative for renal outpatients. Contemp Nurse. 2015;50(2-3):206-13. https://doi.org/10.1080/10376178.2015.1031721.
  5. Fotiadou E, Georgianos PI, Chourdakis M, Zebekakis PE, Liakopoulos V. Eating during the Hemodialysis Session: a Practice improving nutritional status or a risk factor for ıntradialytic hypotension and reduced dialysis adequacy?. Nutrients. 2020;12(6):1703. https://doi.org/10.3390/nu12061703.
  6. Gharib MS, Nazeih MS, El Said TW. Effect of intradialytic oral nutritional supplementation on nutritional markers in malnourished chronic hemodialysis patients: prospective randomized trial. BMC Nephrol. 2023;24(1):125. https://doi.org/10.1186/s12882-023-03181-7.
  7. Kalantar-Zadeh K, Braglia A, Chow J, Kwon O, Kuwae N, Colman S, Cockram DB, Kopple JD. An anti-inflammatory and antioxidant nutritional supplement for hypoalbuminemic hemodialysis patients: a pilot/feasibility study. J Ren Nutr. 2005;15(3):318-31. https://doi.org/10.1016/j.jrn.2005.04.004.
  8. Scott MK, Shah NA, Vilay AM, Thomas J 3rd, Kraus MA, Mueller BA. Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients. J Ren Nutr. 2009;19(2):145-52. https://doi.org/10.1053/j.jrn.2008.08.004.
  9. Kistler BM, Benner D, Burrowes JD, Campbell KL, Fouque D, Garibotto G, et al. Eating during hemodialysis treatment: a Consensus Statement From the International Society of Renal Nutrition and Metabolism. J Ren Nutr. 2018;28(1):4-12. https://doi.org/10.1053/j.jrn.2017.10.003.
  10. Kooman J, Basci A, Pizzarelli F, Canaud B, Haage P, Fouque D, et al. EBPG guideline on haemodynamic instability. Nephrol Dial Transplant. 2007;22 Suppl 2:ii22-44. https://doi.org/10.1093/ndt/gfm019.
  11. Agarwal R, Georgianos P. Feeding during dialysis-risks and uncertainties. Nephrol Dial Transplant. 2018;33(6):917-22. https://doi.org/10.1093/ndt/gfx195.
  12. San Juan Miguelsanz M, Pilar SM, Santos de Pablos MR. Reduction of Kt/V by food intake during haemodialysis. EDTNA ERCA J. 2001;27(3):150-2. https://doi.org/10.1111/j.1755-6686.2001.tb00165.x.
  13. Singri N, Johnstone D, Paparello J, Khosla N, Ahya SN, Ghossein C, et al. Effect of predialysis eating on measurement of urea reduction ratio and Kt/V. Adv Chronic Kidney Dis. 2004;11(4):398-403. https://doi.org/10.1053/j.arrt.2004.04.008.
  14. Rao NS, Chandra A, Saran S, Kulshreshta MR, Mishra P, Tiwari P. Predialytic versus intradialytic nutrition: a study to assess effects on intradialytic blood pressure, dialysis adequacy, and urea removal. Blood Purif. 2021;50(6):823-8. https://doi.org/10.1159/000512540.
  15. Choi MS, Kistler B, Wiese GN, Stremke ER, Wright AJ, Moorthi RN, et al. Pilot study of the effects of high-protein meals during hemodialysis on intradialytic hypotension in patients undergoing maintenance hemodialysis. J Ren Nutr. 2019;29(2):102-11. https://doi.org/10.1053/j.jrn.2018.06.002.
  16. Kittiskulnam P, Banjongjit A, Metta K, Tiranathanagul K, Avihingsanon Y, Praditpornsilpa K, et al. The beneficial effects of intradialytic parenteral nutrition in hemodialysis patients with protein energy wasting: a prospective randomized controlled trial. Sci Rep. 2022;12(1):4529. https://doi.org/10.1038/s41598-022-08726-8.
  17. Fotiadou E, Georgianos PI, Vaios V, Sgouropoulou V, Divanis D, Karligkiotis A, et al. Feeding during dialysis increases ıntradialytic blood pressure variability and reduces dialysis adequacy. Nutrients. 2022;14(7):1357. https://doi.org/https:// 10.3390/nu14071357.
  18. Weisbord SD, Fried LF, Arnold RM, Rotondi AJ, Fine MJ, Levenson DJ, et al. Development of a symptom assessment instrument for chronic hemodialysis patients: the Dialysis Symptom Index. J Pain Symptom Manage. 2004;27(3):226-40. https://doi.org/10.1016/j.jpainsymman.2003.07.004.
  19. Önsöz HB, Usta Yesilbalkan Ö. Reliability and validity of the Turkish version of the dialysis symptom index in chronic hemodialysis patients. Turkish Nephrology Dialysis and Transplantation Journal. 2013; 22(1):60-7. https://doi.org/10.5262/tndt.2013.1001.08.
  20. Fleishman TT, Dreiher J, Shvartzman P. Patient-reported outcomes in maintenance hemodialysis: a cross-sectional, multicenter study. Qual Life Res. 2020;29(9):2345-54. https://doi.org/10.1007/s11136-020-02508-3.
  21. Chauhan K, Wen HH, Gupta N, Nadkarni G, Coca S, Chan L. Higher symptom frequency and severity after the long interdialytic interval in patients on maintenance intermittent hemodialysis. Kidney Int Rep. 2022;7(12):2630-38. https://doi.org/10.1016/j.ekir.2022.09.032.
  22. You AS, Kalantar SS, Norris KC, Peralta RA, Narasaki Y, Fischman R, et al. Dialysis symptom index burden and symptom clusters in a prospective cohort of dialysis patients. J Nephrol. 2022;35(5):1427-36. https://doi.org/10.1007/s40620-022-01313-0.
  23. Zhou M, Gu X, Cheng K, Wang Y, Zhang N. Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study. BMC Nephrol. 2023;24(1):115. https://doi.org/10.1186/s12882-023-03176-4.
  24. Mechta Nielsen T, Marott T, Hornum M, Feldt-Rasmussen B, Kallemose T, Thomsen T. Non-adherence, medication beliefs and symptom burden among patients receiving hemodialysis -a cross-sectional study. BMC Nephrol. 2023;24(1):321. https://doi.org/10.1186/s12882-023-03371-3.
  25. Zhu L, Li XL, Shi R, Wang DG. Dialysis vintage is associated with a high prevalence and severity of unpleasant symptoms in patients on hemodialysis. Ren Fail. 2023;45(1):2201361. https://doi.org/10.1080/0886022X.2023.2201361.
  26. Bossola M, Di Stasio E, Antocicco M, Panico L, Pepe G, Tazza L. Fatigue is associated with increased risk of mortality in patients on chronic hemodialysis. Nephron. 2015;130(2):113-8. https://doi.org/10.1159/000430827.
  27. Ayala M, Marchant M, Hertz C, Castillo G. Intradialytic nutrition and quality of life in Chilean older patients in hemodialysis with protein-energy wasting. Int Urol Nephrol. 2022;54(8):1947-55. https://doi.org/10.1007/s11255-021-03077-1
  28. López-Cisneros S, Ramos-Acevedo S, Reyes-Ramírez LM, Rodríguez-Gómez L, Serralde-Zúñiga AE, González-Ortiz A, et al. Does intradialytic oral nutrition impact hemodialysis patients' quality of life, appetite, and safety? a pilot study of a crossover clinical trial. Nutr Hosp. 2024;41(2):315-25. https://doi.org/10.20960/nh.04703.
  29. Karaaslan T, Pembegul I. Relationship between symptom burden and dialysis adequacy in patients with chronic kidney disease undergoing hemodialysis. North Clin Istanb. 2023;10(4):435-43. https://doi.org/10.14744/nci.2023.01799.
  30. Benner D, Brunelli SM, Brosch B, Wheeler J, Nissenson AR. Effects of oral nutritional supplements on mortality, missed dialysis treatments, and nutritional markers in hemodialysis patients. J Ren Nutr. 2018;28(3):191-6. https://doi.org/10.1053/j.jrn.2017.10.002.
  31. Svinth-Johansen C, Reinhard M, Ivarsen P. Hemodynamic response to glucose-insulin infusion and meals during hemodialysis. Kidney Blood Press Res. 2020;45(2):249-62. https://doi.org/10.1159/000506012.
  32. Wu Y, Lu J, Wang T, Zhu X, Xue J, You L. Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study. Ren Fail. 2024;46(1):2296612. https://doi.org/10.1080/0886022X.2023.2296612.