TY - JOUR
T1 - The Relationship Between Intradialytic Nutrition and Gastrointestinal Symptoms Using a Modified Version of the Gastrointestinal Symptom Rating Scale
AU - Kistler, Brandon M.
AU - Biruete, Annabel
AU - Chapman-Novakofski, Karen
AU - Wilund, Kenneth R.
N1 - Funding Information:
Financial Disclosure: B.M.K. was funded by an American Heart Association Predoctoral Fellowship. A.B. is a predoctoral fellow through CONACyT (the Mexico Council of Science and Technology) and has received funding from the Renal Research Institute. K.C.-.N. has no disclosures relevant to this paper. K.W. has received funding from the National Institutes of Health and the Renal Research Institute.
Publisher Copyright:
© 2017 National Kidney Foundation, Inc.
PY - 2018/3
Y1 - 2018/3
N2 - 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.
AB - 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.
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U2 - 10.1053/j.jrn.2017.08.006
DO - 10.1053/j.jrn.2017.08.006
M3 - Article
C2 - 29471989
AN - SCOPUS:85042088998
SN - 1051-2276
VL - 28
SP - 129
EP - 134
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
IS - 2
ER -