Eating during haemodialysis did not reduce adequacy or fatigue, but blood pressure fell further

Design

Randomised two-period, two-sequence crossover trial

Population

32 maintenance haemodialysis patients, two centres in Türkiye

Primary outcome

Dialysis adequacy (URR, spKt/V) and fatigue

Effect

No difference in adequacy or fatigue; larger intradialytic BP falls with eating

A randomised two-period crossover trial in two Turkish outpatient haemodialysis centres, in Revista da Escola de Enfermagem da USP (September 2026), gave 36 patients (32 completing) standardised food during dialysis in one period and none in the other.

Urea reduction ratio, single-pool Kt/V and fatigue did not differ between periods. Eating was associated with larger falls in systolic and diastolic blood pressure, especially in the second hour. There were no clinically relevant adverse events.

The trial was small, and it did not measure nutritional outcomes, which are the reason for feeding in the first place. But it answers the commonest objection — that eating reduces dialysis efficiency — while flagging the haemodynamic risk.

• Do not withhold food during dialysis on the grounds of reduced adequacy — none was seen
• Watch blood pressure closely in the second hour if a patient eats during dialysis
• Be cautious with intradialytic meals in patients prone to intradialytic hypotension
• Consider feeding malnourished patients during dialysis, with haemodynamic monitoring

Why it matters

It weighs a common unit policy — no food on dialysis — against the nutritional needs of haemodialysis patients.

Don't overread it

A small crossover trial of 32 patients that did not measure nutritional status or longer-term outcomes.

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