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The Relationship Between Intradialytic Nutrition and Gastrointestinal Symptoms Using a Modified Version of the Gastrointestinal Symptom Rating Scale.


ABSTRACT:

Objective

Intradialytic nutrition has been shown to improve nutritional status in maintenance hemodialysis (HD) patients but remains controversial due in part to concerns over hemodynamic stability and gastrointestinal (GI) distress. There are limited data on the relationship between intradialytic nutrition and GI symptoms, possibly due to the lack of a validated tool. Therefore, we intended to validate a questionnaire to measure GI symptoms associated with a single HD treatment and determine the relationship between intradialytic nutrition and GI symptoms.

Design

Cross-sectional study. Forty-eight maintenance HD patients.

Main outcome measure

GI symptoms and dietary intake during HD treatment.

Results

In general, we found acceptable internal consistency (Cronbach's alpha >0.5, exception reflux domain) and repeatability in all 5 domains of a modified version of the Gastrointestinal Symptom Rating Scale. The prevalence of GI symptoms associated with a single HD treatment (generalized score greater than 1) was 54.2, 43.7, 6.2, 41.7, and 45.8% for the abdominal pain, indigestion, reflux, diarrhea, and constipation domains, respectively. More than two-thirds of patients chose to eat during treatment (168.6 ± 165.6 kcal) with the most commonly consumed items being candy, oral supplements, and cookies. There was no difference in GI symptoms among patients who did or did not eat (P > .05). However, the amount of total dietary fat and fiber consumed during treatment was associated with greater indigestion (P < .05) prior to accounting for outliers or multiple comparisons.

Conclusion

In this sample, the modified version of the Gastrointestinal Symptom Rating Scale was a generally valid tool for measuring GI symptoms associated with a single HD treatment. Patients who ate during treatment did not experience greater GI symptoms than those who did not; however, high amounts of fat and fiber may be associated with greater GI symptoms. Prospective trials should examine the relationship between GI symptoms and dietary intake during treatment in HD patients.

SUBMITTER: Kistler BM 

PROVIDER: S-EPMC10436647 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Publications

The Relationship Between Intradialytic Nutrition and Gastrointestinal Symptoms Using a Modified Version of the Gastrointestinal Symptom Rating Scale.

Kistler Brandon M BM   Biruete Annabel A   Chapman-Novakofski Karen K   Wilund Kenneth R KR  

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 20180301 2


<h4>Objective</h4>Intradialytic nutrition has been shown to improve nutritional status in maintenance hemodialysis (HD) patients but remains controversial due in part to concerns over hemodynamic stability and gastrointestinal (GI) distress. There are limited data on the relationship between intradialytic nutrition and GI symptoms, possibly due to the lack of a validated tool. Therefore, we intended to validate a questionnaire to measure GI symptoms associated with a single HD treatment and dete  ...[more]

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