Richard A. Sherman, MD
Synopsis: Sherman RA, Torres F, Cody RP. Postprandial blood pressure changes during hemodialysis. American Journal of Kidney Diseases 1988; 12: 37-9.
Though eating during hemodialysis sessions is a widespread practice, it may lower blood pressure, probably due to a reduction in peripheral vascular resistance from food's effect on alimentary tract blood flow. A prospective controlled study of 125 dialysis treatments in 9 non-diabetic patients dialyzed in the conventional manner (i.e., thrice weekly sessions of 4 or less hours each) revealed that diastolic and mean blood pressures declined significantly faster in the 45 minutes after eating in the fed patients compared with blood pressure changes during equivalent times in control treatments.
During this study period, symptomatic hypotension was seen on 2 occasions (in one single patient) only in 63 fasting treatments compared with 13 episodes in 5 patients in "fed" treatments.
Eating has adverse effects on hemodynamics during dialysis and should be avoided in patients with intradialytic hypotension.
Commentary by Todd S. Ing, MD
Dr. Sherman's study suggests that it is not prudent to eat shortly before or during conventional hemodialysis treatments, lest intradialytic hypotension occur.
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